Individual provider Active NPI

Susan Quigley, MD

  • Physical Medicine & Rehabilitation Physician
  • Minneapolis, MN
National Provider Identifier
1063442804
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
PT16025 Issued in ND
Practice address
2525 Chicago Ave
Minneapolis, MN 55404-4518
Phone
(612) 813-6000
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD60570885 WA
Pediatric Rehabilitation Medicine Physician 2081P0010X MD60570885 WA
Pediatric Rehabilitation Medicine Physician 2081P0010X 01074112 IN
Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician 2081P0301X MD60570885 WA
Physical Medicine & Rehabilitation Physician 208100000X PT16025 ND Primary

Addresses

Primary practice location

2525 Chicago Ave
Minneapolis, MN 55404-4518

Mailing address

2525 Chicago Ave
Minneapolis, MN 55404-4597
Phone (612) 813-6000

Other identifiers 2

IdentifierTypeStateIssuer
201230330MedicaidIN
802719600MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, CA, ND3 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
I20151001003245 WA Practitioner - Pediatric MedicinePractitioner - Physical Medicine and Rehabilitation 0042254443 Reassigns benefits to 1 organization
I20170411002148 CA Practitioner - Physical Medicine and Rehabilitation 0042254443 Reassigns benefits to 1 organization
I20191115002463 ND Practitioner - Physical Medicine and Rehabilitation 0042254443 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01074112INMDPediatric Rehabilitation Medicine Physician
MD60570885WAMDPediatric Rehabilitation Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Pediatrics CurrentSince Aug 10, 2015 Accepting new patients
Multicare Health System Current Accepting new patients
Valley Children'S Medical Group Pediatrics CurrentSince Apr 1, 2017 Accepting new patients
Altru Health System CurrentSince Aug 21, 2020 Accepting new patients
Altru Health System CurrentSince Aug 21, 2020 Accepting new patients
Multicare Health System CurrentSince Aug 10, 2015 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Childrens Health Care Past Accepting new patients

Locations

1524 McHenry Ave
Ste 550
Modesto, CA 95350
Phone (209) 557-5995

1524 McHenry Ave
Ste 550570
Modesto, CA 95350
Phone (209) 572-3880

736 Broadway N
Fargo, ND 58102
Phone (701) 234-2353

1380 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 795-2000

1300 S Columbia Rd
Grand Forks, ND 58201
Phone (701) 780-2300

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

200 Lilly Rd NE
Ste C
Olympia, WA 98506
Phone (360) 918-8336

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Organizations & group practices 8

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1063442804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044597",
            "telephone_number": "612-813-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044518",
            "telephone_number": "612-813-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIGLEY",
        "first_name": "SUSAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2023-06-01",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60570885",
            "primary": false
        },
        {
            "code": "2081P0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
            "state": "WA",
            "license": "MD60570885",
            "primary": false
        },
        {
            "code": "2081P0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
            "state": "IN",
            "license": "01074112",
            "primary": false
        },
        {
            "code": "2081P0301X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Brain Injury Medicine",
            "state": "WA",
            "license": "MD60570885",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "ND",
            "license": "PT16025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201230330",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "802719600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.