Individual provider Active NPI

Susan Margaret Landgraf, MD

  • Family Medicine Physician
  • Shortsville, NY
National Provider Identifier
1205944006
Registry record updated Apr 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
179278 Issued in NY
Practice address
15 Canandaigua St
Shortsville, NY 14548-9763
Phone
(585) 396-6990
Fax
(585) 396-6995
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 179278 NY Primary

Addresses

Primary practice location

15 Canandaigua St
Shortsville, NY 14548-9763

Mailing address

3170 West St
Canandaigua, NY 14424-1712
Phone (585) 396-6990

Other identifiers 3

IdentifierTypeStateIssuer
01388274MedicaidNY
P010179278OtherNYEXCELLUS
110346BFOtherNYPREFERRED CARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address slandgraf83121@direct.urmc.rochester.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20050923000036 NY Practitioner - Family Practice 0143254938 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
179278NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Frederick Ferris Thompson Hospital CurrentSince Aug 5, 2005 Accepting new patients
The Frederick Ferris Thompson Hospital CurrentSince Aug 5, 2005 Accepting new patients

Locations

350 Parrish St
Canandaigua, NY 14424
Phone (585) 396-6000

73 Buffalo St
Ste 100
Canandaigua, NY 14424

3170 West St
Ste 100
Canandaigua, NY 14424
Phone (585) 396-6990

3170 West St
Canandaigua, NY 14424
Phone (585) 396-6190

15 Canandaigua St
Shortsville, NY 14548
Phone (585) 289-3560

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1205944006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3170 WEST ST",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241712",
            "telephone_number": "585-396-6990",
            "fax_number": "585-396-6995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CANANDAIGUA ST",
            "city": "SHORTSVILLE",
            "state": "NY",
            "postal_code": "145489763",
            "telephone_number": "585-396-6990",
            "fax_number": "585-396-6995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDGRAF",
        "first_name": "SUSAN",
        "middle_name": "MARGARET",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "179278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01388274",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLUS",
            "identifier": "P010179278",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "110346BF",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "slandgraf83121@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shortsville, NY

Sources for this page

Verify at the official NPI Registry.