Susan L Elizondo, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

227968 Issued in MA

Practice address

359-A West Highway 264
St Michaels, AZ 86511-0370

Phone

(928) 810-3800

Fax

(928) 810-3801

NPI assigned

May 27, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Northern Apache County Special Health Care District

  • Primary Care Clinic/Center
  • St Michaels, AZ
  • NPI 1326147893
  NPD (past)

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347840000000",
    "number": "1033166038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "address_2": "359-A WEST HIGHWAY 264",
            "city": "ST MICHAELS",
            "state": "AZ",
            "postal_code": "865110370",
            "telephone_number": "928-810-3800",
            "fax_number": "928-810-3801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "359-A WEST HIGHWAY 264",
            "city": "ST MICHAELS",
            "state": "AZ",
            "postal_code": "865110370",
            "telephone_number": "928-810-3800",
            "fax_number": "928-810-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIZONDO",
        "first_name": "SUSAN",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-27",
        "last_updated": "2012-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "227968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "Z135040",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "156365",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• @ Heart Home Care
• Amanda L Beekman, MA, OTRL
• Pernell Kevin Begaye
• Melvina E. Bigthumb, M.S.
• Rez Liwag Cortez
• Patricia F Hogan, LCSW, LMT
• Erica Lynn Kish, PT, MPT
• Northern Apache County Special Health Care District
• Northern Apache County Special Health Care District
• Northern Apache County Special Health Care District

• Family Medicine Physician in St Michaels, AZ
• Providers in St Michaels, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.