Individual provider Active NPI

Susan S Stewart, P.A.-C

  • Medical Physician Assistant
  • Wailuku, HI
National Provider Identifier
1194728139
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
AMD-974 Issued in HI
Practice address
Maui Medical Group
2180 Main Street
Wailuku, HI 96793
Phone
(808) 242-6464
Fax
(808) 244-0603
NPI assigned
May 23, 2005
Last updated
Jul 31, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 003587 GA
Medical Physician Assistant 363AM0700X AMD-974 HI Primary

Addresses

Primary practice location

Maui Medical Group
2180 Main Street
Wailuku, HI 96793

Mailing address

Maui Medical Group
2180 Main Street
Wailuku, HI 96793
Phone (808) 242-6464

Other identifiers 1

IdentifierTypeStateIssuer
00211373DMedicaidGA

Other names 1

  • Miss Susan J Sweeney Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20200803002145 HI Practitioner - Physician Assistant 5496918690 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Emory University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maui Medical Group IncGroup PAC ID 7214823368, 68 clinicians

Practice addresses (Care Compare)

2180 Main St
Wailuku, HI 96793-1625
Phone (808) 242-6464

221 Mahalani St
Wailuku, HI 96793-2526
Phone (808) 242-9056

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.93 of 100Reported as group
Quality
70.26
Promoting interoperability
90
Improvement activities
40
Cost
87.85

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3587GAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Maui Health System a Kaiser Foundation Hospitals LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1194728139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MAUI MEDICAL GROUP",
            "address_2": "2180 MAIN STREET",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "96793",
            "telephone_number": "808-242-6464",
            "fax_number": "808-244-0603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MAUI MEDICAL GROUP",
            "address_2": "2180 MAIN STREET",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "96793",
            "telephone_number": "808-242-6464",
            "fax_number": "808-244-0603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "SUSAN",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-23",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "003587",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "HI",
            "license": "AMD-974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00211373D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "SWEENEY",
            "middle_name": "J",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wailuku, HI

Sources for this page

Verify at the official NPI Registry.