SUSAN M HIMES PHD
NPI 1215260104
Psychologist - Clinical in Burlington, MA
NPI Status: Active since September 10, 2009
Contact Information
41 MALL RD
LAHEY HOSPITAL AND MEDICAL CENTER
BURLINGTON, MA
ZIP 01805
Phone: (781) 744-8610
Fax: (781) 744-5235
- Individual
- Female
- Years of Experience 17
- Psychologist
- Clinical
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About SUSAN HIMES
This page provides the complete NPI Profile along with additional information for Susan Himes, a provider established in Burlington, Massachusetts with a medical specialization in Psychologist, focusing in clinical and more than 17 years of experience. She graduated from University Of South Florida College Of Medicine in 2009. The healthcare provider is registered in the NPI registry with number 1215260104 assigned on September 2009. The practitioner's primary taxonomy code is 103TC0700X with license number 10102 (MA). The provider is registered as an individual and her NPI record was last updated 10 years ago.
- NPI
- 1215260104
- Provider Name
- SUSAN M HIMES PHD
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 41 MALL RD LAHEY HOSPITAL AND MEDICAL CENTER BURLINGTON, MA 01805
- Location Phone
- (781) 744-8610
- Location Fax
- (781) 744-5235
- Mailing Address
- 41 MALL RD LAHEY HOSPITAL AND MEDICAL CENTER BURLINGTON, MA 01805
- Mailing Phone
- (781) 744-8610
- Mailing Fax
- (781) 744-5235
- Medical School Name
- UNIVERSITY OF SOUTH FLORIDA COLLEGE OF MEDICINE
- Graduation Year
- 2009
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-10-2009
- Last Update Date
- 03-30-2015
- Code Navigator
A clinical psychologist like Susan Himes assesses, diagnoses, and treats mental, emotional, and behavioral disorders. Clinical psychologists help people deal with problems ranging from short-term personal issues to severe, chronic conditions. Clinical psychologists interview patients, give diagnostic tests, provide psychotherapy and design behavior modification programs to help patients.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychologist Clinical
- Taxonomy Code
- 103TC0700X
- Type
- Behavioral Health & Social Service Providers
- License No.
- 10102
- License State
- MA
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 103TC0700X | Behavioral Health & Social Service Providers | Psychologist | PS01295 (RI) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Preferred Blue PPO 5000/10%/8000 w/HSA - PPO
- Anthem Bronze Preferred Blue PPO 5000/20%/8000 w/HSA - PPO
- Anthem Bronze Preferred Blue PPO 6500/30%/9200 Value - PPO
- Anthem Bronze Preferred Blue PPO 7000/50%/8000 w/HSA - PPO
- Anthem Bronze Preferred Blue PPO 8500/50%/9200 - PPO
- Anthem Gold Preferred Blue PPO 1000/20%/7500 - PPO
- Anthem Gold Preferred Blue PPO 2000/0%/6500 RxD - PPO
- Anthem Gold Preferred Blue PPO 2000/10%/4600 w/HSA - PPO
- Anthem Gold Preferred Blue PPO 2000/10%/7500 - PPO
- Anthem Gold Preferred Blue PPO 2000/20%/4600 w/HSA - PPO
- Anthem Gold Preferred Blue PPO 3000/0%/5500 RxD - PPO
- Anthem Gold Preferred Blue PPO 500/25%/7000 - PPO
- Anthem Platinum Preferred Blue PPO 250/10%/3500 - PPO
- Anthem Silver Preferred Blue PPO 2000/30%/9000 Value - PPO
- Anthem Silver Preferred Blue PPO 3000/20%/8500 - PPO
- Anthem Silver Preferred Blue PPO 3000/30%/9000 Value - PPO
- Anthem Silver Preferred Blue PPO 3500/20%/7250 w/HSA - PPO
- Anthem Silver Preferred Blue PPO 4000/0%/8500 - PPO
- Anthem Silver Preferred Blue PPO 4000/0%/8500 RxD - PPO
- Anthem Silver Preferred Blue PPO 4000/10%/7250 w/HSA - PPO
- Anthem Bronze Pathway X Enhanced 6000/35% HSA - HMO
- Anthem Bronze Pathway X Enhanced 6500/40% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway X Enhanced 7500/50% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
- Anthem Catastrophic Pathway X Enhanced 9200/0% - HMO
- Anthem Gold Pathway X Enhanced 1200/20% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Gold Pathway X Enhanced 1500/25% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
- Anthem Gold Pathway X Enhanced 700/40% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Heart Healthy Bronze Pathway X Enhanced 6000/30% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Heart Healthy Silver Pathway X Enhanced 4000/0% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Silver Pathway X Enhanced 4500/20% HSA - HMO
- Anthem Silver Pathway X Enhanced 5000/40% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
- Anthem Silver Pathway X Enhanced 5500/20% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Access Blue New England HMO 5000/10%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 5000/20%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 6500/30%/9200 Value - HMO
- Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
- Anthem Bronze Pathway X HMO 5000/10%/8000 w/HSA - HMO
- Anthem Bronze Pathway X HMO 5000/20%/8000 w/HSA - HMO
- Anthem Bronze Pathway X HMO 6500/30%/9200 Value - HMO
- NH Local Choice HMO Bronze 8000 - HMO
- NH Local Choice HMO Gold - HMO
- NH Local Choice HMO Gold 1400 - HMO
- NH Local Choice HMO HSA Bronze 6000 - HMO
- NH Local Choice HMO Silver 3500 - HMO
- NH Local Choice HMO Silver 5000 - HMO
- NH Local HMO Bronze 7500 Standard - HMO
- NH Local HMO Gold 1500 Standard - HMO
- NH Local HMO Silver 5000 Standard - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Susan Himes is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Susan Himes is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 3072760552
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20150512002329
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Group psychotherapy
Psychiatric diagnostic evaluation
Psychotherapy, 30 minutes
Group psychotherapy involves individuals discussing their issues in a group setting, led by a professional therapist. It provides a supportive environment where members can learn from each other's experiences, gain different perspectives, and develop new ways to handle challenges.
This service was performed 93 times for 26 patientsA psychiatric diagnostic evaluation is a thorough assessment used to identify any mental health conditions you may have. It involves a detailed discussion about your symptoms, thoughts, feelings and behavior patterns. Your medical history and family's mental health history are also considered.
This service was performed 42 times for 42 patientsPsychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 30-minute session, the therapist helps you explore feelings, thoughts, and behaviors to better understand yourself and manage life's challenges.
This service was performed 213 times for 45 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $47.46 for a new patient copayment and $27.79 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 01805 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99205
- Average New Patient Price $189.86
- Minimum New Patient Price $63.72
- Maximum New Patient Price $189.86
- Average New Patient Copayment $47.46
- Minimum New Patient Copayment $15.93
- Maximum New Patient Copayment $47.46
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $111.18
- Minimum Established Patient Price $21.07
- Maximum Established Patient Price $155.29
- Average Established Patient Copayment $27.79
- Minimum Established Patient Copayment $5.26
- Maximum Established Patient Copayment $38.82
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 1 | 5 | 2 | 6 | 0 | 1 | 0 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 2 | 5 | 4 | 6 | 0 | 1 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 2 + 5 + 4 + 6 + 0 + 1 + 0 + 24 = 46 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 46 = 4 | 4 | ||||||||
The NPI number 1215260104 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1578562674 | KAREN ORINO CRNA Individual | Nurse Anesthetist, Certified Registered | 41 MALL RD BURLINGTON, MA 01805 (781) 744-5100 |
| 1205836582 | MANUEL J MERINO MD Individual | Urology | 41 MALL RD LAHEY CLINIC BURLINGTON, MA 01805 (781) 744-7284 |
| 1598759961 | DR. BENJAMIN ARI TILLINGER MD Individual | Internal Medicine (Cardiovascular Disease) | 41 MALL RD CARDIOVASCULAR MEDICINE BURLINGTON, MA 01805 (781) 744-8000 |
| 1710977228 | ANTHONY P WEINER MD Individual | Psychiatry & Neurology (Psychiatry) | 41 MALL RD BURLINGTON, MA 01805 (781) 744-8610 |
| 1447240858 | DR. LATA CHANDI THATAI MD Individual | Internal Medicine (Hematology & Oncology) | 41 MALL RD LAHEY CLINIC BURLINGTON, MA 01805 (781) 744-8400 |
| 1780675074 | DR. LESLIE PAULETTE SHAFF MD Individual | Anesthesiology | 41 MALL RD BURLINGTON, MA 01805 (781) 744-7299 |
| 1881676096 | DR. DILIP NATARAJ MD Individual | Internal Medicine (Pulmonary Disease) | 41 MALL RD LAHEY CLINIC, INC. BURLINGTON, MA 01805 (781) 744-8480 |
| 1629050315 | HEATHER L TORRE PA-C Individual | Physician Assistant | 41 MALL RD BURLINGTON, MA 01805 (781) 372-7000 |
| 1649254715 | TIMOTHY F. KAISER MD Individual | Family Medicine (Geriatric Medicine) | 41 MALL RD LAHEY CLINIC, DEPARTMENT OF GERIATRICS BURLINGTON, MA 01805 (781) 744-2086 |
| 1285610014 | DR. ARTUR ZEMBOWICZ MD, PH D Individual | Pathology (Dermatopathology) | 41 MALL RD LAHEY CLINIC BURLINGTON, MA 01805 (781) 744-3927 |
| 1023088697 | BRAD P MANUEL PAC Individual | Physician Assistant (Medical) | 41 MALL RD BURLINGTON, MA 01805 (781) 744-2273 |
| 1407821358 | MS. JEAN E FISCHER PA-C Individual | Physician Assistant | 41 MALL RD LAHEY CLLINIC MEDICAL CENTER-CARDIOTHORACIC SURGERY BURLINGTON, MA 01805 (781) 744-8570 |
| 1134188659 | DR. ADAM JAMES VERNADAKIS M.D. Individual | Plastic Surgery | 41 MALL RD LAHEY CLINIC, INC. - PLASTIC SURGERY BURLINGTON, MA 01805 (781) 744-8582 |
| 1689634800 | SUSAN M HURLEY NP Individual | Nurse Practitioner | 41 MALL RD BURLINGTON, MA 01805 (781) 744-5100 |
| 1487616660 | THOMAS D. WOLD DO Individual | Internal Medicine (Pulmonary Disease) | 41 MALL RD BURLINGTON, MA 01805 (781) 744-8480 |
| 1134184815 | JASON R GEE MD Individual | Urology | 41 MALL RD BURLINGTON, MA 01805 (781) 744-5100 |
| 1649238577 | ARTHUR P MOURTZINOS M.D. Individual | Urology | 41 MALL RD BURLINGTON, MA 01805 (781) 744-5481 |
| 1568411320 | YAMIN DOU M.D. Individual | Nuclear Medicine (Nuclear Imaging & Therapy) | 41 MALL RD LAHEY CLINIC BURLINGTON, MA 01805 (781) 744-8170 |
| 1649225046 | YEVGENIY ARSHANSKIY M.D. Individual | Radiology (Diagnostic Radiology) | 41 MALL RD LAHEY CLINIC MEDICAL CENTER BURLINGTON, MA 01805 (781) 744-8170 |
| 1164478368 | ANDRES J SOLORZA M.D. Individual | Hospitalist | 41 MALL RD LAHEY CLINIC BURLINGTON, MA 01805 (781) 744-7000 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1215260104, enumerated in the NPI registry as an "individual" on September 10, 2009
The provider is located at 41 Mall Rd Lahey Hospital And Medical Center Burlington, Ma 01805 and the phone number is (781) 744-8610
The provider's speciality is Psychologist with taxonomy code 103TC0700X with a focus in Clinical
The provider has more than 17 years of experience. She graduated from University Of South Florida College Of Medicine in 2009.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Sheld, Anthem Blue. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
Medicare beneficiaries should expect a typical cost of $189.86 with an average copayment of $47.46 for new patient appointments. Established patients should expect a typical charge of $111.18 and an average copayment of 27.79. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Group psychotherapy, Psychiatric diagnostic evaluation and Psychotherapy, 30 minutes.
This NPI record was last updated on September 10, 2009. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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