Individual provider Active NPI

Susanne Ragg, MD, PHD

  • Pediatric Hematology & Oncology Physician
  • Indianapolis, IN
National Provider Identifier
1104919091
Registry record updated Sep 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
ME137616 Issued in FL
Practice address
705 Riley Hospital Dr
Roc 4340
Indianapolis, IN 46202-5109
Phone
(317) 944-5611
Fax
(317) 944-3107
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Hematology & Oncology Physician 2080P0207X ME137616 FL Primary
Pediatric Hematology & Oncology Physician 2080P0207X 01045089 IN

Addresses

Primary practice location

705 Riley Hospital Dr
Roc 4340
Indianapolis, IN 46202-5109

Mailing address

PO Box 1026
Indianapolis, IN 46206-1026
Phone (317) 274-1201

Other identifiers 1

IdentifierTypeStateIssuer
200218020MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20181109002618 FL Practitioner - Pediatric MedicinePractitioner - Hematology/Oncology 1658338470 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians Inc CurrentSince Oct 1, 2018 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Current Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Oct 1, 2018 Accepting new patients
Major Hospital Past Accepting new patients

Locations

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

Organizations & group practices 4

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538006400000",
    "number": "1104919091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1026",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462061026",
            "telephone_number": "317-274-1201",
            "fax_number": "317-278-9905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 RILEY HOSPITAL DR",
            "address_2": "ROC 4340",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025109",
            "telephone_number": "317-944-5611",
            "fax_number": "317-944-3107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGG",
        "first_name": "SUSANNE",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2018-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "FL",
            "license": "ME137616",
            "primary": true
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "IN",
            "license": "01045089",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200218020",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.