NPIMap

Individual provider Active NPI

Susanna Margaryan, MD

  • Internal Medicine Physician
  • Ephrata, PA
National Provider Identifier
1225221930
Registry record updated Oct 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD443516 Issued in PA
Practice address
169 Martin Ave
Ephrata, PA 17522-1724
Phone
(717) 733-6546
Fax
(717) 733-6010
NPI assigned
Aug 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD443516 PA Primary
Hospitalist Physician 208M00000X MD443516 PA

Addresses

Primary practice location

169 Martin Ave
Ephrata, PA 17522-1724

Mailing address

PO Box 398
Brownstown, PA 17508-0398
Phone (717) 556-1600

Other identifiers 1

IdentifierTypeStateIssuer
102638058MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140610001547 CA Practitioner - Internal Medicine 9830360460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Inpatient PhysiciansGroup PAC ID 4789998170, 35 clinicians

Practice addresses (Care Compare)

147 N Brent St
Ventura, CA 93003-2809
Phone (805) 652-5652

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Inpatient Physicians Hospitalist CurrentSince Jul 1, 2015 Accepting new patients

Locations

1306 Maricopa Hwy
Ojai, CA 93023
Phone (805) 640-2260

4904 Telegraph Rd
Ventura, CA 93003
Phone (805) 542-4101

147 N Brent St
Ventura, CA 93003
Phone (805) 652-5011

Organizations & group practices 1

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.

Hospital & facility affiliations 12

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": "1188086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349913600000",
    "number": "1225221930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 398",
            "city": "BROWNSTOWN",
            "state": "PA",
            "postal_code": "175080398",
            "telephone_number": "717-556-1600",
            "fax_number": "717-556-1632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 MARTIN AVE",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175221724",
            "telephone_number": "717-733-6546",
            "fax_number": "717-733-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARGARYAN",
        "first_name": "SUSANNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-26",
        "last_updated": "2012-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD443516",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "MD443516",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102638058",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ephrata, PA

Sources for this page

Verify at the official NPI Registry.