Active NPI
Susan Haesaert, OD
- Optometrist
- Boston, MA
National Provider Identifier
1992750111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2415
- Practice address
- 150 S Huntington Ave
Boston, MA 02130-4817 - Phone
- (617) 232-9500
- NPI assigned
- May 24, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2415 | TN | Primary |
Addresses
Primary practice location
150 S Huntington Ave
Boston, MA 02130-4817
Mailing address
Boston VA Healthcare System
150 South Huntington Avenue
Boston, MA 02130
Phone (617) 232-9500
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2415 | TN | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992750111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BOSTON VA HEALTHCARE SYSTEM",
"address_2": "150 SOUTH HUNTINGTON AVENUE",
"city": "BOSTON",
"state": "MA",
"postal_code": "02130",
"telephone_number": "617-232-9500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 S HUNTINGTON AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021304817",
"telephone_number": "617-232-9500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAESAERT",
"first_name": "SUSAN",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TN",
"license": "2415",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.