Individual provider Active NPI

Susan Wozniak, MD, MBA

  • Surgery Physician
  • Baltimore, MD
National Provider Identifier
1053759407
Registry record updated Jun 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
P28836 Issued in MD
Practice address
2401 W Belvedere Ave
Baltimore, MD 21215-5216
Phone
(410) 601-9000
NPI assigned
Jun 7, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X P28836 MD Primary

Addresses

Primary practice location

2401 W Belvedere Ave
Baltimore, MD 21215-5216

Mailing address

2401 W Belvedere Ave
Baltimore, MD 21215-5216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC, TX3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20160620001398 MD Practitioner - General Surgery 2264662964 Reassigns benefits to 3 organizations
I20160913000338 DC Practitioner - General Surgery 2264662964 Reassigns benefits to 1 organization
I20181218002404 TX Practitioner - General Surgery 2264662964 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
P28836MDMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Hospital Center, Inc Surgery CurrentSince Aug 1, 2016 Accepting new patients
Sinai Hospital of Baltimore Inc Surgery CurrentSince Dec 17, 2016 Accepting new patients
Sinai Hospital of Baltimore, Inc. CurrentSince Dec 17, 2016 Accepting new patients
Eobert Marriott Medical Corp Surgery CurrentSince Sep 1, 2018 Accepting new patients
Northwest Hospital Center, Inc. CurrentSince Aug 1, 2016 Accepting new patients
Sinai Hospital of Baltimore Inc Current Accepting new patients
Robert Marriott Medical Corp Surgery CurrentSince May 9, 2016 Accepting new patients
Northwest Hospital Center, Inc. Past Accepting new patients
Sinai Hospital of Baltimore Inc Surgery Past Accepting new patients

Locations

222 N Pacific Coast Hwy
Ste 2175
El Segundo, CA 90245
Phone (877) 850-8762

222 N Pacific Coast Hwy
Ste 1420
El Segundo, CA 90245

4000 River Crescent Dr
Annapolis, MD 21401
Phone (410) 224-8108

2435 W Belvedere Ave
Ste 42
Baltimore, MD 21215
Phone (410) 601-5547

2401 W Belvedere Ave
Baltimore, MD 21215

3210 Powder Mill Rd
Hyattsville, MD 20783
Phone (301) 937-3939

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

330 W Ben White Blvd
Austin, TX 78704
Phone (512) 705-7383

1175 Denton St
Beaumont, TX 77707
Phone (409) 842-3120

810 E 13th Ave
Belton, TX 76513
Phone (254) 939-1876

1103 Mary Jane St
Belton, TX 76513
Phone (254) 939-9327

10777 Westheimer Rd
Ste 1100
Houston, TX 77042
Phone (713) 260-9671

Organizations & group practices 9

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": "1370563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370563200000",
    "number": "1053759407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 W BELVEDERE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W BELVEDERE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155216",
            "telephone_number": "410-601-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOZNIAK",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "MD, MBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-07",
        "last_updated": "2013-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "P28836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.