NPIMap

Individual provider Active NPI

Jason V. Sustersic, D.O.

  • Family Medicine Physician
  • Independence, OH
National Provider Identifier
1124056163
Registry record updated Dec 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34-008460 Issued in OH
Practice address
6571 Brecksville Rd
Independence, OH 44131-4848
Phone
(216) 233-5996
NPI assigned
Jun 29, 2006
Last updated
Dec 23, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34-008460 OH Primary

Addresses

Primary practice location

6571 Brecksville Rd
Independence, OH 44131-4848

Mailing address

5617 Biddulph Ave
Cleveland, OH 44144-3504

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jasonsustersic@uhps.allscriptsdirect.net
Direct Messaging Address jasonsustersic@uhps.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050620000413 OH Practitioner - Family Practice 5193769255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

158 W Main Rd
Conneaut, OH 44030-2039

5901 E Royalton Rd
Broadview Heights, OH 44147-3532

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.15 of 100Reported as apm
Quality
82.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34-008460OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc Current Accepting new patients
University Primary Care Practices Inc CurrentSince Aug 15, 2015 Accepting new patients
University Primary Care Practices Inc CurrentSince Aug 15, 2015 Accepting new patients
University Hospitals Medical Group Inc Past Accepting new patients

Locations

5901 E Royalton Rd
Ste 2600
Broadview Heights, OH 44147
Phone (216) 524-8883

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

5672 Ridge Rd
Parma, OH 44129
Phone (440) 886-0770

Interoperability endpoints

  • Direct secure messaging: jsustersic36032@ehrdirect.uhhospitals.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1124056163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5617 BIDDULPH AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441443504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6571 BRECKSVILLE RD",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441314848",
            "telephone_number": "216-233-5996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSTERSIC",
        "first_name": "JASON",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34-008460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jasonsustersic@uhps.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "5850 Ridge Rd Ste C",
            "city": "Parma",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441293169",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jasonsustersic@uhps.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "5901 E Royalton Rd Ste 2600",
            "city": "Broadview Hts",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441473532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Independence, OH

Sources for this page

Verify at the official NPI Registry.