RITA DE-HAAN SULLIVAN (PH.D) – Clinical Psychologist, NPI 1417034794
Clinical Psychologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
647 CLINICAL PSYCHOLOGIST in OR
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Provider Addresses for RITA DE-HAAN SULLIVAN (PH.D)
West Main Street, Medford, Jackson County, Oregon, 97501, United States
SUITE 1B
MEDFORD, OR 975012744
Phone: (541) 944-5711
Type: Location
Medford Post Office, Passageway, Medford Square, West Medford, Medford, Middlesex County, Massachusetts, 02155, United States
MEDFORD, OR 975010154
Phone: (541) 944-5711
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2017-01-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20170112002405 | I | Clinical Psychologist | OR | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 96131 | Evaluation of psychological test, each additional hour | 50 | 13 | $0 |
| 90791 | Psychiatric diagnostic evaluation | 14 | 14 | $0 |
| 96130 | Evaluation of psychological test, first hour | 13 | 13 | $0 |
Insurance plans in this area (ZIP 97501)
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