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DR. SUSAN J SAMPL PH.D.
NPI 1285768754
Psychologist - Clinical in Avon, CT

Active since March 15, 2007PECOS Enrolled
34 DALE RD STE 212, AVON, CT 06001(860) 803-9167 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Susan J Sampl Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SUSAN J SAMPL PH.D. (NPI 1285768754) is an individual clinical provider in Avon, Connecticut, licensed in Connecticut (1848) and active in the NPI registry since March 2007. She is enrolled in Medicare PECOS and is a graduate of Other (1992).

NPPES Registry Identity

NPI1285768754
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. SUSAN J SAMPLCredential: PH.D.
Location Address34 DALE RD STE 212Avon, CT 06001-3659
Mailing Address34 Dale Rd Ste 212Avon, CT 06001-3659 · (860) 803-9167
Phone(860) 803-9167
Sole ProprietorYes
Medical School CMSOtherGraduated 1992
Enumeration DateMarch 15, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1285768754 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in CT · 1848
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
34 DALE RD STE 212, Avon, CT 06001
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Susan J Sampl Ph.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3870016256
PECOS Enrollment IDI20250326001895
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Susan Sampl reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Psychological Health & Development Associates, LLC
12 mi
Psychologist
433 SILAS DEANE HWY
Wethersfield, CT 06109
  • Reassigned Medicare billing, Connecticut enrollment
  • 6 clinicians in this Medicare group
NPI 1144519968 (860) 338-5911

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06001 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$183.10 typical visit price
range $60.82 – $183.10
Typical copayment $45.77 (range $15.20 – $45.77)
Most-billed visit code 99205
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Susan Sampl's NPI number?

The NPI number for Susan Sampl is 1285768754. It was assigned to this individual provider in the NPPES registry on March 15, 2007.

Where is Susan Sampl located?

Susan Sampl practices at 34 Dale Rd Ste 212, Avon, CT 06001. The listed phone number is (860) 803-9167.

What is Susan Sampl's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Susan Sampl enrolled in Medicare?

Yes. Susan Sampl is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Susan Sampl's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Susan Sampl reassigns Medicare benefits to Psychological Health & Development Associates, LLC (Wethersfield, CT). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Susan Sampl's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Susan Sampl was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.