Susannah Jensen, MD

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

Practice address

2650 Ridge Ave Ste 5303
Evanston, IL 60201-1718

Phone

(847) 570-1463

Fax

(847) 578-8647

NPI assigned

Oct 13, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, HI2 enrollments

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 2

Specialty

Internal MedicineAlso: General Surgery

Education

University of Texas Medical School at San Antonio, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sjensen50665@direct.rush.rush-health.com

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.

• Queens University Medical Group

  • Multi-Specialty Clinic/Center
  • Honolulu, HI
  • NPI 1891441382

  General Acute Care Hospital

  Medicare reassignment Care Compare group NPD
• Endeavor Health Medical Group

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882
  Medicare reassignment NPD
• Rush Oak Park Nocturnist

  • Internal Medicine Physician
  • Oak Park, IL
  • NPI 1518260165
  Medicare reassignment NPD
• Rush Oak Park Physicians Group Adult Medicine

  • Adult Medicine Physician
  • Oak Park, IL
  • NPI 1548531924
  Medicare reassignment NPD
• The Queen'S Medical Center

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1487693586
  Medicare reassignment NPD
• Endeavor Health Medical Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD
• The Queens Medical Center

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1184612764
  NPD

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

{
    "created_epoch": "1223856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428451200000",
    "number": "1194977827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE STE 5303",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE STE 5303",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718",
            "telephone_number": "847-570-1463",
            "fax_number": "847-578-8647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "SUSANNAH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-13",
        "last_updated": "2015-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Senecal Occupational Therapy Services LLC
• Jennifer Stevens
• Carol Dianne Jennings, LCPC
• Nancy L. Jensen, PHD
• Stephanie Marie Jensen, MD
• Gihane E. Jeremie-Brink, PH.D.
• Jeremy Arron Schwartz DPM LTD
• Stephanie Jeret
• Phoebe Jerousek, OTD, OTR/L
• Jerry S. Kreiman, Ma, Acsw, LTD

• General Acute Care Hospital in Evanston, IL
• Providers in Evanston, IL by specialty
• General Acute Care Hospital in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.