Stephanie R Middaugh, PSYD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

005100 Issued in AZ

Practice address

3115 S Price Rd
Chandler, AZ 85248-3544

Phone

(480) 855-4011

NPI assigned

Apr 15, 2019

Last updated

Apr 15, 2019By 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 names 1

• Stephanie R Olson Former name

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Neuroglia PLLCGroup PAC ID 7113352915, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Neuroglia PLLC

  dba Gilbert Neuropsychology

  • Clinical Neuropsychologist
  • Gilbert, AZ
  • NPI 1952949380
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1699338863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1736 E GAIL DR",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852258712",
            "telephone_number": "602-708-6338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 S PRICE RD",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852483544",
            "telephone_number": "480-855-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDAUGH",
        "first_name": "STEPHANIE",
        "middle_name": "R",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-15",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "AZ",
            "license": "005100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "OLSON",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael J. Fucci MD, PC (Arizona Hearing and Balance Center)
• Michael Shaikewitz DC LTD
• Sultan Ghila Michael, M.D
• Vanessa Michael, PA-C
• Emily N. Mickelson
• Jessica Pollard Midkiff, DPT PT
• Matthew Allan Grayson Midkiff, PT DPT CSCS
• Shaine Midkiff
• Dominique Mikula
• Gayle D Milek, FNP-C

• Clinical Neuropsychologist in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Clinical Neuropsychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2019; 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.