Individual provider Active NPI

Susan E Cusson, APRN

  • Family Nurse Practitioner
  • Bedford, MA
National Provider Identifier
1043367030
Registry record updated Mar 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN174128 Issued in MA
Practice address
100 Old Billerica Rd
Carleton-Willard Village
Bedford, MA 01730-1267
Phone
(781) 275-8700
Fax
(781) 276-1934
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN174128 MA Primary

Addresses

Primary practice location

100 Old Billerica Rd
Carleton-Willard Village
Bedford, MA 01730-1267

Mailing address

100 Old Billerica Rd
Carleton-Willard Village
Bedford, MA 01730-1267
Phone (781) 275-8700

Other identifiers 2

IdentifierTypeStateIssuer
NP2935OtherMABCBSMA
110076851AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031118000120 MA Practitioner - Nurse Practitioner 2466366018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carleton-Willard Homes IncGroup PAC ID 0941215586, 2 clinicians

Practice addresses (Care Compare)

100 Old Billerica Rd
Bedford, MA 01730-1283
Phone (781) 275-8700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN174128MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carleton-Willard Homes, Inc. CurrentSince Sep 3, 2013 Accepting new patients

Locations

100 Old Billerica Rd
Bedford, MA 01730
Phone (781) 275-8700

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425945600000",
    "number": "1043367030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 OLD BILLERICA RD",
            "address_2": "CARLETON-WILLARD VILLAGE",
            "city": "BEDFORD",
            "state": "MA",
            "postal_code": "017301267",
            "telephone_number": "781-275-8700",
            "fax_number": "781-276-1934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 OLD BILLERICA RD",
            "address_2": "CARLETON-WILLARD VILLAGE",
            "city": "BEDFORD",
            "state": "MA",
            "postal_code": "017301267",
            "telephone_number": "781-275-8700",
            "fax_number": "781-276-1934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSSON",
        "first_name": "SUSAN",
        "middle_name": "E",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2015-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN174128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMA",
            "identifier": "NP2935",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110076851A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, MA

Sources for this page

Verify at the official NPI Registry.