Active NPI
Susanna J Mopper, MD
- Anesthesiology Physician
- Aurora, CO
National Provider Identifier
1154715506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- DR.0064569
- Practice address
- 12605 E 16TH Ave
Aurora, CO 80045-2545 - Phone
- (720) 848-0000
- NPI assigned
- Mar 24, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 299056-1 | NY | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 63629 | NY | |
| Anesthesiology Physician | 207L00000X | 0064569 | CO | |
| Anesthesiology Physician | 207L00000X | DR.0064569 | CO | Primary |
Addresses
Primary practice location
12605 E 16TH Ave
Aurora, CO 80045-2545
Mailing address
PO Box 110429
Aurora, CO 80042-0429
Other practice location 1
47 New Scotland Ave
Department of Anesthesiology
Albany, NY 12208-3412
Phone (518) 262-4302
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 |
|---|---|---|---|
| 299056 | NY | MD | Licensed Practical Nurse |
| 0064569 | CO | MD | Anesthesiology Physician |
| 299056-1 | NY | MD | Anesthesiology Physician |
| 63629 | NY | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664150400000",
"number": "1154715506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 110429",
"city": "AURORA",
"state": "CO",
"postal_code": "800420429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12605 E 16TH AVE",
"city": "AURORA",
"state": "CO",
"postal_code": "800452545",
"telephone_number": "720-848-0000"
}
],
"practiceLocations": [
{
"address_1": "47 New Scotland Ave",
"address_2": "Department of Anesthesiology",
"address_purpose": "LOCATION",
"city": "Albany",
"state": "NY",
"postal_code": "122083412",
"country_code": "US",
"telephone_number": "518-262-4302",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOPPER",
"first_name": "SUSANNA",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-24",
"last_updated": "2022-09-26",
"certification_date": "2022-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NY",
"license": "299056-1",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NY",
"license": "63629",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CO",
"license": "0064569",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CO",
"license": "DR.0064569",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Aurora, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.