Individual provider Active NPI

Susan Pena Almazan, MD

  • Pediatric Endocrinology Physician
  • Dayton, OH
National Provider Identifier
1164501573
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
35.088487 Issued in OH
Practice address
1 Childrens PLZ
Dayton, OH 45404-1873
Phone
(937) 641-4000
Fax
(937) 641-4500
NPI assigned
Nov 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X 35.088487 OH Primary
Pediatrics Physician 208000000X 35.088487 OH

Addresses

Primary practice location

1 Childrens PLZ
Dayton, OH 45404-1873

Mailing address

PO Box 933432
Cleveland, OH 44193-0039
Phone (937) 641-5072

Other practice location 1

3333 W Tech Rd
Miamisburg, OH 45342-0955
Phone (937) 641-4000

Other identifiers 1

IdentifierTypeStateIssuer
2681245MedicaidOH

Other names 1

  • Susan Pena Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20191114002102 OH Practitioner - Endocrinology 3870925779 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.088487OHMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dayton Children'S Specialty Physicians, Inc. Pediatrics CurrentSince Oct 11, 2019 Accepting new patients
Dayton Children'S Specialty Physicians, Inc. Pediatrics CurrentSince Oct 11, 2019 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1 Childrens Plz
Dayton, OH 45404
Phone (937) 641-3600

967 Bellefontaine Ave
Lima, OH 45804
Phone (419) 224-1330

3333 W Tech Rd
Miamisburg, OH 45342
Phone (937) 641-3400

Organizations & group practices 3

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": "1162598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1164501573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 933432",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930039",
            "telephone_number": "937-641-5072",
            "fax_number": "937-641-6129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PLZ",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454041873",
            "telephone_number": "937-641-4000",
            "fax_number": "937-641-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 W Tech Rd",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453420955",
            "country_code": "US",
            "telephone_number": "937-641-4000",
            "fax_number": "937-641-6492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALMAZAN",
        "first_name": "SUSAN",
        "middle_name": "PENA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-04",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "OH",
            "license": "35.088487",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.088487",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2681245",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "PENA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.