Active NPI
Susan L Ban, M.D.
- Internal Medicine Physician
- Tustin, CA
National Provider Identifier
1053324970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A81987
- Practice address
- 17400 Irvine Blvd
Suite F
Tustin, CA 92780-3030 - Phone
- (714) 838-5610
- NPI assigned
- Aug 14, 2006
- Last updated
- Aug 30, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A81987 | CA | Primary |
Addresses
Primary practice location
17400 Irvine Blvd
Suite F
Tustin, CA 92780-3030
Mailing address
15000 Kensington Park Dr
Ste 360
Tustin, CA 92782-1835
Phone (714) 838-5610
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W1779 | Other | CA | GROUP ID |
| 1689633125 | Other | CA | GROUP NPI |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- University of Southern California Keck School of Medicine, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
15000 Kensington Park Dr
Suite 360
Tustin, CA 92782-1835
Phone (714) 838-5610
Hospital & facility affiliations
- Hoag Home Health
- Providence at Home With Compassus Home Health, Orange County South
- Hoag Memorial Hospital Presbyterian
- Providence St. Joseph Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.94 of 100
- Quality
- 69.88
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A81987 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Joseph Health Northern California, LLC | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- susanban@tustinirvi.allscriptsdirect.net
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.
-
- Internal Medicine Physician
- Tustin, CA
- NPI 1689633125
-
dba Providence St. Joseph Hospital
- General Acute Care Hospital
- Eureka, CA
- NPI 1609858950
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Providence at Home with Compassus Home Health, Orange County South
- Home Health Agency
- Irvine, CA
- NPI 1396567533
-
- Home Health Agency
- Newport Beach, CA
- NPI 1174192892
-
- General Acute Care Hospital
- Newport Beach, CA
- NPI 1518951300
-
dba Providence St. Joseph Hospital
- General Acute Care Hospital
- Orange, CA
- NPI 1912982216
-
dba Providence St. Joseph Hospital
- General Acute Care Hospital
- Orange, CA
- NPI 1558575746
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567123200000",
"number": "1053324970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15000 KENSINGTON PARK DR",
"address_2": "STE 360",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927821835",
"telephone_number": "714-838-5610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17400 IRVINE BLVD",
"address_2": "SUITE F",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927803030",
"telephone_number": "714-838-5610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAN",
"first_name": "SUSAN",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-14",
"last_updated": "2019-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A81987",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP ID",
"identifier": "W1779",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1689633125",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tustin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2019; 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.