Individual provider Active NPI

Susan G Woods, MD

  • Dermatology Physician
  • Youngstown, OH
National Provider Identifier
1013960319
Registry record updated Dec 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
35067749 Issued in OH
Practice address
20 Ohltown Rd
Youngstown, OH 44515-2331
Phone
(330) 884-1557
Fax
(330) 799-0261
NPI assigned
May 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 35067749 OH Primary
Procedural Dermatology Physician 207NS0135X 35067749 OH

Addresses

Primary practice location

20 Ohltown Rd
Youngstown, OH 44515-2331

Mailing address

20 Ohltown Rd
Youngstown, OH 44515-2331
Phone (330) 884-1557

Other identifiers 1

IdentifierTypeStateIssuer
0170096MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060919000388 OH Practitioner - Dermatology 0143225516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35067749OHMDProcedural Dermatology Physician
35.067749OHMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Susan Woods MD Dermatology Inc Dermatology CurrentSince Aug 1, 2006 Accepting new patients

Locations

20 Ohltown Rd
Youngstown, OH 44515
Phone (330) 797-9705

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387238400000",
    "number": "1013960319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 OHLTOWN RD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445152331",
            "telephone_number": "330-884-1557",
            "fax_number": "330-799-0261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 OHLTOWN RD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445152331",
            "telephone_number": "330-884-1557",
            "fax_number": "330-799-0261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODS",
        "first_name": "SUSAN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2013-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35067749",
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "OH",
            "license": "35067749",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0170096",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.