Individual provider Active NPI

Rachel Sina Sussman, MD

  • Family Medicine Physician
  • San Jose, CA
National Provider Identifier
1184064396
Registry record updated Apr 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A133996 Issued in CA
Practice address
455 Oconnor Dr Ste 210
San Jose, CA 95128-1632
Phone
(408) 283-7767
NPI assigned
Jul 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Internal Medicine) Physician 207RA0401X A133996 CA
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X A133996 CA Primary

Addresses

Primary practice location

455 Oconnor Dr Ste 210
San Jose, CA 95128-1632

Mailing address

455 Oconnor Dr Ste 210
San Jose, CA 95128-1632
Phone (408) 283-7767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20180226001376 CA Practitioner - Family Practice 5395006811 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Stanford University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Indian Health Center of Santa Clara ValleyGroup PAC ID 1153406665, 37 clinicians
University Healthcare AllianceGroup PAC ID 6305748799, 334 clinicians

Practice addresses (Care Compare)

1642 E Capitol Expy
San Jose, CA 95121-1800
Phone 40844534003730

455 Oconnor Dr
Suite 210
San Jose, CA 95128-1632
Phone (408) 995-5453

Hospital & facility affiliations

  • Santa Clara Valley Medical Center Hospital, San Jose, CA, CCN 050038
  • Stanford Health Care Hospital, Stanford, CA, CCN 050441

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A133996CAMDAddiction Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indian Health Center of Santa Clara Valley CurrentSince Aug 19, 2018 Accepting new patients
University Healthcare Alliance CurrentSince Jan 2, 2018 Accepting new patients
Indian Health Center of Santa Clara Valley CurrentSince Aug 19, 2018 Accepting new patients
Affinity Medical Group Past Accepting new patients

Locations

50 E Hamilton Ave
Ste 280
Campbell, CA 95008
Phone (408) 227-2646

14251 Winchester Blvd
#200
Los Gatos, CA 95032
Phone (408) 426-5540

1300 Crane St
Menlo Park, CA 94025
Phone (510) 785-5000

455 Oconnor Dr
Ste 210
San Jose, CA 95128
Phone (408) 831-5744

2410 Samaritan Dr
Ste 201
San Jose, CA 95124
Phone (408) 371-9010

1642 E Capitol Expy
San Jose, CA 95121
Phone (408) 270-0112

1333 Meridian Ave
San Jose, CA 95125

455 Oconnor Dr
Ste 200
San Jose, CA 95128
Phone (408) 283-7666

Interoperability endpoints

  • Direct secure messaging: rsussman582774@direct.ochin.org
  • Direct secure messaging: rsussman47817@santaclaravalley.direct-ci.net
  • Direct secure messaging: rsussman50795@direct.stanfordhealthcare.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 and National Provider Directory roles.

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": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1184064396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 OCONNOR DR STE 210",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281632",
            "telephone_number": "408-283-7767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 OCONNOR DR STE 210",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281632",
            "telephone_number": "408-283-7767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSSMAN",
        "first_name": "RACHEL",
        "middle_name": "SINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-02",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "CA",
            "license": "A133996",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A133996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.