Active NPI
Susanna Thomas, M.D.
- Family Medicine Physician
- Old Saybrook, CT
National Provider Identifier
1093726192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 028170
- Practice address
- 1250 Boston Post Rd
Old Saybrook, CT 06475-4405 - Phone
- (860) 388-9250
- Fax
- (860) 388-9687
- NPI assigned
- Aug 11, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 028170 | CT | Primary |
Addresses
Primary practice location
1250 Boston Post Rd
Old Saybrook, CT 06475-4405
Mailing address
1250 Boston Post Rd
Old Saybrook, CT 06475-4405
Phone (860) 388-9250
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010028170CT01 | Other | CT | ANTHEM BLUE SHIELD |
| 028170 | Other | CT | CONNECTICARE |
| 2143945 | Other | CT | AETNA |
| 0R0177 | Other | CT | HEALTHNET |
| 080121849 | Other | CT | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 028170 | CT | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1260835200000",
"number": "1093726192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1250 BOSTON POST RD",
"city": "OLD SAYBROOK",
"state": "CT",
"postal_code": "064754405",
"telephone_number": "860-388-9250",
"fax_number": "860-388-9687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 BOSTON POST RD",
"city": "OLD SAYBROOK",
"state": "CT",
"postal_code": "064754405",
"telephone_number": "860-388-9250",
"fax_number": "860-388-9687"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "SUSANNA",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-11",
"last_updated": "2009-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CT",
"license": "028170",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE SHIELD",
"identifier": "010028170CT01",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONNECTICARE",
"identifier": "028170",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2143945",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET",
"identifier": "0R0177",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "080121849",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Old Saybrook, CT
- Daniel M. Terray Jr., DC
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- The Right Choice Physical Therapy South, Inc
- The Stop & Shop Supermarket Company, LLC (Stop and Shop Pharmacy #688)
- Jennifer Thomas
- Three Graces, LLP (Avia Counseling Center)
- Tidal Counseling LLC
- Suzanne Tingley, MD
- Claudia Titelman, PHD
- Lisa Uihlein
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.