Individual provider Active NPI

Edwin F. Sause, PH.D.

  • Psychologist
  • Tampa, FL
National Provider Identifier
1790805497
Registry record updated Sep 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
004290-1 Issued in NY
Practice address
5707 N 22ND St
Tampa, FL 33610-4350
Phone
(813) 707-7240
NPI assigned
Mar 29, 2007
Last updated
Sep 18, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2008

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pastoral Counselor 101YP1600X
Addiction (Substance Use Disorder) Psychologist 103TA0400X 004290-1 NY
Counseling Psychologist 103TC1900X 004290-1 NY
Psychologist 103T00000X 004290-1 NY Primary

Addresses

Primary practice location

5707 N 22ND St
Tampa, FL 33610-4350

Mailing address

PO Box 3834
Plant City, FL 33563-0014
Phone (813) 441-4699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
004290-1NYMDSurgical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221696000000",
    "number": "1790805497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3834",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335630014",
            "telephone_number": "813-441-4699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5707 N 22ND ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336104350",
            "telephone_number": "813-707-7240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUSE",
        "first_name": "EDWIN",
        "middle_name": "F.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2008-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "004290-1",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NY",
            "license": "004290-1",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "004290-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.