Individual provider Active NPI

Susan Marie Haas, O.D.

  • Optometrist
  • Joplin, MO
National Provider Identifier
1417060153
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TO3474 Issued in MO
Practice address
2623 West 7TH Street
Joplin, MO 64801
Phone
(417) 206-4880
NPI assigned
Aug 16, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TO3474 MO Primary

Addresses

Primary practice location

2623 West 7TH Street
Joplin, MO 64801

Mailing address

1816 S Michigan Ave
Joplin, MO 64804-0948
Phone (417) 781-3027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080828000053 MO Practitioner - Optometry 0840366803 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TO3474MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Eyecare, LLC Optometrist CurrentSince Sep 19, 2009 Accepting new patients

Locations

101 N Range Line Rd
Ste 186
Joplin, MO 64801
Phone (417) 782-9151

2825 S Glenstone Ave
Ste 113
Springfield, MO 65804
Phone (417) 887-6883

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1417060153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1816 S MICHIGAN AVE",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648040948",
            "telephone_number": "417-781-3027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2623 WEST 7TH STREET",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "64801",
            "telephone_number": "417-206-4880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAS",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "TO3474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.