Individual provider Active NPI

Susmita B. Nesargi, MD

  • Pediatric Anesthesiology Physician
  • Wilmington, DE
National Provider Identifier
1023100815
Registry record updated Jan 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
C10007321 Issued in DE
Practice address
A.I. Dupont Hospital for Children
1600 Rockland Road
Wilmington, DE 19803-3607
Phone
(302) 651-4000
Fax
(302) 651-4945
NPI assigned
Sep 29, 2006
Last updated
Jan 11, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X C10007321 DE
Pediatric Anesthesiology Physician 207LP3000X C10007321 DE Primary

Addresses

Primary practice location

A.I. Dupont Hospital for Children
1600 Rockland Road
Wilmington, DE 19803-3607

Mailing address

Nemours Childrens Clinic
P.O. Box 404112
Atlanta, GA 30384-0001
Phone (904) 390-3610

Other identifiers 6

IdentifierTypeStateIssuer
4058259MedicaidMD
0044466MedicaidNJ
0265061MedicaidNY
065412000MedicaidMN
101105860MedicaidPA
0596973MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20041111000521 DE Practitioner - Anesthesiology 6901869726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Nemours FoundationGroup PAC ID 9537072483, 249 clinicians

Practice addresses (Care Compare)

1600 Rockland Rd
Wilmington, DE 19803-3607
Phone (302) 651-4200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C10007321DEMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation CurrentSince Aug 30, 2016 Accepting new patients
The Nemours Foundation CurrentSince Aug 30, 2016 Accepting new patients

Locations

1600 Rockland Rd
Wilmington, DE 19803

30 Worthington Blvd
Malvern, PA 19355
Phone (302) 651-5204

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326240000000",
    "number": "1023100815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NEMOURS CHILDRENS CLINIC",
            "address_2": "P.O. BOX 404112",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303840001",
            "telephone_number": "904-390-3610",
            "fax_number": "904-288-5890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "A.I. DUPONT HOSPITAL FOR CHILDREN",
            "address_2": "1600 ROCKLAND ROAD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198033607",
            "telephone_number": "302-651-4000",
            "fax_number": "302-651-4945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESARGI",
        "first_name": "SUSMITA",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2012-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "DE",
            "license": "C10007321",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "DE",
            "license": "C10007321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4058259",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0044466",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0265061",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "065412000",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101105860",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0596973",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.