Clifford L. Sussman, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A45906 Issued in CA

Practice address

150 W. Foothill Blvd
San Dimas, CA 91773-1102

Phone

(909) 599-9921

Fax

(909) 592-3147

NPI assigned

Jun 27, 2005

Reactivated

Apr 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Internal Medicine

Education

University of Texas Medical Branch at Galveston, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• San Dimas Family Care Inc.

  • Family Medicine Physician
  • San Dimas, CA
  • NPI 1104856947
  NPD (past) Authorized official
• San Dimas Family Clinic

  • Internal Medicine Physician
  • San Dimas, CA
  • NPI 1750944286
  NPD (past) Authorized official
• Emanate Health Foothill Presbyterian Hospital

  • General Acute Care Hospital
  • Glendora, CA
  • NPI 1992733513
  NPD (past)
• San Dimas Community Hospital, Inc.

  • Skilled Nursing Facility
  • San Dimas, CA
  • NPI 1568487619
  NPD (past)

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228953600000",
    "number": "1033115688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 W. FOOTHILL BLVD",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917731102",
            "telephone_number": "909-599-9921",
            "fax_number": "909-592-3147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W. FOOTHILL BLVD",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917731102",
            "telephone_number": "909-599-9921",
            "fax_number": "909-592-3147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSSMAN",
        "first_name": "CLIFFORD",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2008-12-11",
        "deactivation_date": "2006-03-17",
        "reactivation_date": "2006-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A45906",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A45906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Renae Stewart
• Geovanna Alejandra Stingley, COTA
• Alicia M Stufoso, OT
• Clifford F Stunden, MFT
• Gerardo Cuitlahuac Suarez
• Suzan Burmayan, O.D., a Professional Corporation
• David Ashley Swearingen, OD
• Shahid Syed, M.D.
• Syngo LLC
• William H Tabb, DPM

• Family Medicine Physician in San Dimas, CA
• Providers in San Dimas, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.