Lyssa T Haase, PSYD in Salt Lake City, UT - Medicare Psychologist Provider

Lyssa T Haase, PSYD is a medicare enrolled "Psychologist" provider in Salt Lake City, Utah. Her current practice location is 5770 S 1500 W, Salt Lake City, Utah. You can reach out to her office (for appointments etc.) via phone at (801) 313-7770.

Lyssa T Haase is licensed to practice in Utah (license number 10069932-2501) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1053709634.

Contact Information

	Lyssa T Haase, PSYD
	5770 S 1500 W, Salt Lake City, UT 84123-5216
	(801) 313-7770
	(801) 313-7771

Map and Direction

Healthcare Provider's Profile

Full Name	Lyssa T Haase
Gender	Female
Speciality	Psychologist
Location	5770 S 1500 W, Salt Lake City, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1053709634
Provider Enumeration Date: 01/05/2015
Last Update Date: 08/29/2024

Medicare PECOS Information:

PECOS PAC ID: 5092053181
Enrollment ID: I20190215000284

Medical Identifiers

Medical identifiers for Lyssa T Haase such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1053709634	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103T00000X	Psychologist	4573 (Montana)	Secondary
103T00000X	Psychologist	10069932-2501 (Utah)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Lyssa T Haase allows following entities to bill medicare on her behalf.

Entity Name	Ihc Health Services Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1629260880 PECOS PAC ID: 1850209420 Enrollment ID: O20031105000079

Entity Name	Ihc Health Services Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1942325154 PECOS PAC ID: 1850209420 Enrollment ID: O20080610000303

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lyssa T Haase is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Lyssa T Haase, PSYD Po Box 30180, Salt Lake City, UT 84130-0180 Ph: () -	Lyssa T Haase, PSYD 5770 S 1500 W, Salt Lake City, UT 84123-5216 Ph: (801) 313-7770

Reviews and Comments

Psychologist in Salt Lake City, UT

Dr. Rachel Leigh Hopkins, PSYD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 164 S 900 E, Salt Lake City, UT 84102 Phone: 801-419-0139 Fax: 385-227-8099
Megan Wall, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 464 E 3rd Ave, Salt Lake City, UT 84103 Phone: 609-462-5974
Dr. Charlotte J Ferrin, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1399 S 700 E, Suite 11, Salt Lake City, UT 84105 Phone: 801-231-5795
Kelly Stout, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 295 S Chipeta Way, Salt Lake City, UT 84108 Phone: 801-213-3469
Jordan Kugler, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 170 S 1000 E Ste 201, Salt Lake City, UT 84102 Phone: 402-578-7426
Bruce Dennis Etringer, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 675 E 2100 S Ste 250, Salt Lake City, UT 84106 Phone: 801-467-8890 Fax: 801-484-3862
Dr. Ann H Tyler, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 4505 So Wasatch Blvd, Suite #380, Salt Lake City, UT 84124 Phone: 801-273-7835

Lyssa T Haase, PSYD - Medicare Psychologist in Salt Lake City, UT