Individual provider Active NPI

John R. Sussman, M.D.

  • Obstetrics & Gynecology Physician
  • New Milford, CT
National Provider Identifier
1205833670
Registry record updated May 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
025996 Issued in CT
Practice address
2 Old Park LN
New Milford, CT 06776-2508
Phone
(860) 354-9321
Fax
(860) 350-9304
NPI assigned
Jun 30, 2005
Last updated
May 7, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 025996 CT Primary

Addresses

Primary practice location

2 Old Park LN
New Milford, CT 06776-2508

Mailing address

2 Old Park LN
New Milford, CT 06776-2508
Phone (860) 354-9321

Other identifiers 1

IdentifierTypeStateIssuer
1259969MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20110304000519 CT Practitioner - Obstetrics/Gynecology 4880876317 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

120 Park Lane Rd
Suite A202
New Milford, CT 06776-2445
Phone (860) 354-3584

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.38 of 100Reported as group
Quality
63.01
Promoting interoperability
98
Improvement activities
40
Cost
72.3

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
025996CTMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice CT, Inc. CurrentSince Mar 16, 2020 Accepting new patients
Nuvance Health Medical Practice PC Obstetrics & Gynecology CurrentSince Aug 19, 2019 Accepting new patients

Locations

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

120 Park Lane Rd
Ste A202
New Milford, CT 06776
Phone (860) 350-9070

50 Hospital Hill Rd
Sharon, CT 06069
Phone (860) 364-4000

Interoperability endpoints

  • Direct secure messaging: jsussman11022@direct.med.uchc.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367884800000",
    "number": "1205833670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 OLD PARK LN",
            "city": "NEW MILFORD",
            "state": "CT",
            "postal_code": "067762508",
            "telephone_number": "860-354-9321",
            "fax_number": "860-350-9304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 OLD PARK LN",
            "city": "NEW MILFORD",
            "state": "CT",
            "postal_code": "067762508",
            "telephone_number": "860-354-9321",
            "fax_number": "860-350-9304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSSMAN",
        "first_name": "JOHN",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2013-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CT",
            "license": "025996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1259969",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Milford, CT

Sources for this page

Verify at the official NPI Registry.