Susan M. Gannon, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

234913-1 Issued in NY

Practice address

455 Patroon Creek Blvd.
Suite 101
Albany, NY 12206

Phone

(518) 438-0505

Fax

(518) 438-4517

NPI assigned

Mar 17, 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 1

Medicare fee-for-service enrollment

Enrolled in NY

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 1

Specialty

Plastic and Reconstructive Surgery

Education

Albany Medical College of Union University, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Plastic Surgery Associates LLPGroup PAC ID 3072774546, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Peter'S Hospital Hospital, Albany, NY, CCN 330057

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sgannon788244@direct.trinity-health.org

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.

• Plastic Surgery Associates LLP

  • Specialist
  • Albany, NY
  • NPI 1760757652
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Peter'S Hospital of the City of Albany

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1497701106
  Care Compare affiliation

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390953600000",
    "number": "1063471209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 PATROON CREEK BLVD.",
            "address_2": "SUITE 101",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12206",
            "telephone_number": "518-438-0505",
            "fax_number": "518-438-4517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 PATROON CREEK BLVD.",
            "address_2": "SUITE 101",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12206",
            "telephone_number": "518-438-0505",
            "fax_number": "518-438-4517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNON",
        "first_name": "SUSAN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2014-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "234913-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02685936",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory Gambino, PHARMD, RPH
• Advadella Gamble, RN
• Mit Gandhi
• Mittal Z Gandhi
• Marjorie Alison Gang, LCSW
• Alexis Joanna Gantos
• Ganz
• Hui Gao, LAC
• Nicholas Garafalo
• Kyla Rae Garand, FNP-C

• Specialist in Albany, NY
• Providers in Albany, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2014; 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.

Verify at the official NPI Registry.