Susan Haydar, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3665-57 Issued in WI

Practice address

5471 W Waterford LN
Appleton, WI 54913-8510

Phone

(920) 731-7445

NPI assigned

Feb 10, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WI

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, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Total Life IncGroup PAC ID 8123433034, 113 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Total Life Inc.

  • Group Psychotherapy Psychologist
  • Jupiter, FL
  • NPI 1053909267

  WI

  Medicare reassignment Care Compare group NPD
• Total Life FL PA

  dba Total Life

  • Integrative Medicine Physician
  • Potomac, MD
  • NPI 1447057286

  WI

  Medicare reassignment

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

{
    "created_epoch": "1328832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1730452400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5337 W GRANDE MARKET DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138442",
            "telephone_number": "920-731-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5471 W WATERFORD LN",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138510",
            "telephone_number": "920-731-7445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYDAR",
        "first_name": "SUSAN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-10",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY24934",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "9408",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "3665-57",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "W14158",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "GF591Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "ZZZ20041Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aaron J Hauser, PHARM. D.
• Robert Lee Hausserman, M.D.
• Haven Crest Homes LLC
• Haviland Hearing AIDS Inc.
• Samantha Hawkinson Dodd, MS, ACSM-CEP
• Brandon B Hayes, LP
• Kevin J Hayes, D.O.
• Samuel Hayes, MD
• Sarena Headley
• Healing Sun, LLC

• Clinical Psychologist in Appleton, WI
• Providers in Appleton, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.