Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Susie Bartolome Peterson, CSCDCCC-SLP

Individual provider Speech-Language Pathologist · NPI 1063529956

Dr. Susie Bartolome Peterson, CSCDCCC-SLP is a Qualified Speech Language Pathologist in Honolulu, Hawaii. Qualified in 2016, 10 years ago. Practices with Powerback Rehabilitation LLC, a 616-clinician group and accepts Medicare assignment. Licensed in Hawaii.

Years since qualifying
10
Licensed in
HI
In the registry since
2006
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Practice location Address checks out

677 Ala Moana Blvd Ste 625
Honolulu, HI 96813-5415
Phone: (808) 692-1580
Fax: (808) 566-6292
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence SP-1826 (HI)

Record details

NPI number1063529956
Entity typeIndividual (Type 1)
GenderFemale
Credentials CSCDCCC-SLP
Sole proprietorNo
NPI enumeratedAugust 24, 2006
Last updated in NPPESJanuary 13, 2020
Certification dateJanuary 13, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyQUALIFIED SPEECH LANGUAGE PATHOLOGIST
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Powerback Rehabilitation Llc — 616 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Honolulu