Individual provider Active NPI

Susan Teran, CPNP-PC

  • Pediatric Nurse Practitioner
  • Austin, TX
National Provider Identifier
1073944534
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
755964 Issued in TX
Practice address
1301 Barbara Jordan Blvd
Suite 200
Austin, TX 78723-3077
Phone
(512) 628-1820
Fax
(512) 628-1821
NPI assigned
Dec 10, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 755964 TX Primary

Addresses

Primary practice location

1301 Barbara Jordan Blvd
Suite 200
Austin, TX 78723-3077

Mailing address

1301 Barbara Jordan Blvd Ste 200
Austin, TX 78723-3078
Phone (512) 628-1820

Other identifiers 2

IdentifierTypeStateIssuer
333176101MedicaidTX
333176102MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20140328001784 TX Practitioner - Nurse Practitioner 5496986721 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
755964TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dell Children'S Medical Group CurrentSince Jan 3, 2014 Accepting new patients
Dell Children'S Medical Group CurrentSince Jan 3, 2014 Accepting new patients

Locations

1301 Barbara Jordan Blvd
Ste 200
Austin, TX 78723
Phone (512) 628-1800

Interoperability endpoints

  • Direct secure messaging: susan.russo.1@8363.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1386633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1073944534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 BARBARA JORDAN BLVD STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233078",
            "telephone_number": "512-628-1820",
            "fax_number": "512-628-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 BARBARA JORDAN BLVD",
            "address_2": "SUITE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233077",
            "telephone_number": "512-628-1820",
            "fax_number": "512-628-1821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERAN",
        "first_name": "SUSAN",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-10",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "755964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "333176101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "333176102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.