Individual provider Active NPI

Amelia Ann Hassler, PSYD

  • Psychologist
  • Portland, ME
National Provider Identifier
1851332613
Registry record updated Sep 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS1170 Issued in ME
Practice address
93 Rivers Edge Dr
Portland, ME 04102-1952
Phone
(207) 450-3625
Fax
(313) 672-6160
NPI assigned
Jun 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS1170 ME Primary

Addresses

Primary practice location

93 Rivers Edge Dr
Portland, ME 04102-1952

Mailing address

PO Box 10018
Portland, ME 04104-0018
Phone (207) 450-3625

Other identifiers 1

IdentifierTypeStateIssuer
431891500MedicaidME

Other names 1

  • Mrs. Amelia Hassler Ardisson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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

Enrollment IDStateProvider typePAC IDDetails
I20060119000741 ME Practitioner - Clinical Psychologist 9133143951 Practice locations: Portland, ME

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

93 Rivers Edge Dr
Portland, ME 04102-1952
Phone (207) 450-3625

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411862400000",
    "number": "1851332613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10018",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041040018",
            "telephone_number": "207-450-3625",
            "fax_number": "313-672-6160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 RIVERS EDGE DR",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041021952",
            "telephone_number": "207-450-3625",
            "fax_number": "313-672-6160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSLER",
        "first_name": "AMELIA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2014-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ME",
            "license": "PS1170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "431891500",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMELIA",
            "last_name": "ARDISSON",
            "middle_name": "HASSLER",
            "prefix": "MRS.",
            "credential": "PSYD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.