Individual provider Active NPI

Susan Ranae Swatsworth, PA

  • Medical Physician Assistant
  • Watertown, NY
National Provider Identifier
1164434965
Registry record updated Mar 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
016504 Issued in NY
Practice address
1575 Washington St
Watertown, NY 13601-9371
Phone
(315) 786-7300
Fax
(315) 786-7310
NPI assigned
Aug 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X A354 SC
Medical Physician Assistant 363AM0700X 101592 NC
Medical Physician Assistant 363AM0700X 016504 NY Primary

Addresses

Primary practice location

1575 Washington St
Watertown, NY 13601-9371

Mailing address

1575 Washington St
Watertown, NY 13601-9371
Phone (315) 786-7300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140313000348 NY Practitioner - Physician Assistant 1052580552 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Samaritan Medical CenterGroup PAC ID 8123914876, 157 clinicians

Practice addresses (Care Compare)

10881 US Route 11
Adams, NY 13605-3154
Phone (315) 232-4400

1575 Washington St
Watertown, NY 13601-9371
Phone (315) 779-5060

830 Washington St
Watertown, NY 13601-4034
Phone (315) 785-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
101592NCMDMedical Physician Assistant
016504NYMDMedical Physician Assistant
A354SCMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: susan.swatsworth@sfhcny.eclinicaldirectplus.com

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584921600000",
    "number": "1164434965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 WASHINGTON ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136019371",
            "telephone_number": "315-786-7300",
            "fax_number": "315-786-7310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 WASHINGTON ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136019371",
            "telephone_number": "315-786-7300",
            "fax_number": "315-786-7310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWATSWORTH",
        "first_name": "SUSAN",
        "middle_name": "RANAE",
        "name_prefix": "Miss",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "A354",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "101592",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "016504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

Verify at the official NPI Registry.