Talia E Haiderzad, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

M103571 Issued in MO

Practice address

3001 Warrior LN
Poplar Bluff, MO 63901-8685

Phone

(573) 686-1200

Fax

(573) 686-1029

NPI assigned

Sep 25, 2006

Last updated

Jan 21, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Poplar Bluff Hma Physician Management, LLCGroup PAC ID 5092769703, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Poplar Bluff Regional Medical Center Hospital, Poplar Bluff, MO, CCN 260119

Merit-based Incentive Payment System (MIPS)

Final score

91.41 of 100Reported as apm

Quality

79.26

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

70.1 of 100Reported as group

Quality

41.46

Improvement activities

40

Cost

87.48

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Poplar Bluff Hma Physician Management, LLC

  • Family Medicine Physician
  • Poplar Bluff, MO
  • NPI 1598710147

  Psychiatry

  Medicare reassignment Care Compare group NPD
• Cape Girardeau Behavioral Health LLC

  dba Southeast Behavioral Hospital

  • Psychiatric Hospital
  • Cape Girardeau, MO
  • NPI 1700485281

  Psychiatry

  Medicare reassignment NPD
• Southeast Health Center of Stoddard County, LLC

  dba Mercy Hospital Stoddard

  • Rural Health Clinic/Center
  • Dexter, MO
  • NPI 1790828812
  Medicare reassignment NPD
• Southeast Health Center of Stoddard County LLC

  dba Mercy Hospital Stoddard

  • Family Medicine Physician
  • Dexter, MO
  • NPI 1477997567
  NPD
• Southeast Health Center of Stoddard County, LLC

  dba Mercy Hospital Stoddard

  • Rural Health Clinic/Center
  • Dexter, MO
  • NPI 1457660045
  NPD
• Advanced Psychiatric Services

  • Psychiatry Physician
  • Sullivan, MO
  • NPI 1457303877
  NPD (past)
• Poplar Bluff Regional Medical Center LLC

  dba Poplar Bluff Regional Medical Center

  • General Acute Care Hospital
  • Poplar Bluff, MO
  • NPI 1700831724
  NPD (past)
• Poplar Bluff Regional Medical Center, Inc

  • Diagnostic Radiology Physician
  • Poplar Bluff, MO
  • NPI 1568503357
  NPD (past)
• Success Health System, LLC

  • Psychiatry Physician
  • Columbia, MO
  • NPI 1508310293
  NPD (past)
• Horizon Mental Health Management LLC

  • Psychiatry Physician
  • Lewisville, TX
  • NPI 1255380176
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Poplar Bluff Regional Medical Center LLC

  dba Poplar Bluff Regional Medical Center

  • General Acute Care Hospital
  • Poplar Bluff, MO
  • NPI 1700831724
  Care Compare affiliation

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232496000000",
    "number": "1669572871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 280",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639020280",
            "telephone_number": "573-686-1200",
            "fax_number": "573-686-1029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 WARRIOR LN",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639018685",
            "telephone_number": "573-686-1200",
            "fax_number": "573-686-1029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIDERZAD",
        "first_name": "TALIA",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2009-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "M103571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "255217",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146412001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208103432",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11060304",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fathia Gyamfi, FNP
• Kevin A Hachmeister, DC
• Eden N Hackworth
• Michelle Haga
• Khalil J Haiderzad, M.D.
• Caitlin Halcomb
• Karen Louise Haldeman
• Mary Beth Haldeman, LPC
• Tracy Hale
• Cynthia Aliene Hall I, BA

• Psychiatry Physician in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Psychiatry Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.