Susan J Tate, MD

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

4295 Issued in AK

Practice address

4076 Neely Road
Fort Wainwright, AK 99703

Phone

(907) 361-5479

NPI assigned

Sep 30, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Emergency Medicine Associates PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Fairbanks, AK
  • NPI 1275529109
  NPD (past)
• Maniilaq Association

  dba Maniilaq Health Center

  • Critical Access Hospital
  • Kotzebue, AK
  • NPI 1316995210
  NPD (past)
• Maniilaq Association

  • Community/Behavioral Health Agency
  • Kotzebue, AK
  • NPI 1821297276
  NPD (past)

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1184611519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4076 NEELY ROAD",
            "city": "FT WAINWRIGHT",
            "state": "AK",
            "postal_code": "99703",
            "telephone_number": "907-361-5689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4076 NEELY ROAD",
            "city": "FORT WAINWRIGHT",
            "state": "AK",
            "postal_code": "99703",
            "telephone_number": "907-361-5479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATE",
        "first_name": "SUSAN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-30",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "AK",
            "license": "4295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD0991",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Stayer, RDH
• Cynthia Louise Stinnett
• Thomas S Strain
• Jane A Sublette
• Ann Sutherland
• Brett Terbeek, PA-C
• Kyle Thomas, PA-C
• Laura Anne Thompson, RN
• Michael W. Thwing, MD
• William Thomas Tomlin, PT, DPT, CSCS

• Emergency Medical Services (Emergency Medicine) Physician in Fort Wainwright, AK
• Providers in Fort Wainwright, AK by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.