Individual provider Active NPI

Suzanne Jane Higgins Stewart, MD

  • Pediatrics Physician
  • Placerville, CA
National Provider Identifier
1225492861
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A151595 Issued in CA
Practice address
4341 Golden Center Dr BLDG a
Placerville, CA 95667-6260
Phone
(530) 626-1144
NPI assigned
Apr 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A151595 CA Primary

Addresses

Primary practice location

4341 Golden Center Dr BLDG a
Placerville, CA 95667-6260

Mailing address

4341 Golden Center Dr BLDG a
Placerville, CA 95667-6260
Phone (530) 626-1144

Other practice location 1

1100 Marshall Way
Placerville, CA 95667-6533
Phone (530) 622-1441

Other identifiers 1

IdentifierTypeStateIssuer
1225492861MedicaidCA

Other names 1

  • Suzanne Jane Higgins Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20220405001644 CA Practitioner - Pediatric Medicine 8921494675 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A151595CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Pediatrics CurrentSince Feb 28, 2022 Accepting new patients
Permanente Medical Group Inc Pediatrics Current Accepting new patients
Permanente Medical Group, Inc CurrentSince Feb 28, 2022 Accepting new patients
Marshall Medical Pediatrics Past Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

2155 Iron Point Rd
Folsom, CA 95630
Phone (916) 817-5000

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Organizations & group practices 4

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": "1460246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1225492861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4341 GOLDEN CENTER DR BLDG A",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956676260",
            "telephone_number": "530-626-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4341 GOLDEN CENTER DR BLDG A",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956676260",
            "telephone_number": "530-626-1144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Marshall Way",
            "address_purpose": "LOCATION",
            "city": "Placerville",
            "state": "CA",
            "postal_code": "956676533",
            "country_code": "US",
            "telephone_number": "530-622-1441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEWART",
        "first_name": "SUZANNE",
        "middle_name": "JANE HIGGINS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-10",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A151595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225492861",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2155 Iron Point Rd",
            "city": "Folsom",
            "state": "CA",
            "country_code": "US",
            "postal_code": "956308707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SUZANNE",
            "last_name": "HIGGINS",
            "middle_name": "JANE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Placerville, CA

Sources for this page

Verify at the official NPI Registry.