Susan Kaweski, M.D. a Professional

Primary specialty

SpecialistTaxonomy code 174400000X

License

G53909 Issued in CA

Legal business name

SUSAN KAWESKI, M.D. A PROFESSIONAL

Practice address

8415 Grant Ave
La Mesa, CA 91941-5303

Phone

(619) 464-9876

Fax

(619) 464-9877

NPI assigned

Sep 11, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Susan Kaweski, M.D.NPI 1629076856

Title

President

Phone

(619) 464-9876

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susan Kaweski, M.D., F.A.C.S.

  • Plastic and Reconstructive Surgery Physician
  • La Mesa, CA
  • NPI 1629076856
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244678400000",
    "number": "1154516243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8415 GRANT AVE.",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "91941",
            "telephone_number": "619-464-9876",
            "fax_number": "619-464-9877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8415 GRANT AVE",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919415303",
            "telephone_number": "619-464-9876",
            "fax_number": "619-464-9877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN KAWESKI, M.D. A PROFESSIONAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2009-06-11",
        "status": "A",
        "authorized_official_last_name": "KAWESKI",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-464-9876",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G53909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CGP163644",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1629076856",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.