Active NPI
Susan E Wilden, LISW
- Clinical Social Worker
- San Antonio, TX
National Provider Identifier
1235485301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 00835
- Practice address
- 7272 Wurzbach Rd
601
San Antonio, TX 78240-4801 - Phone
- (210) 615-3483
- Fax
- (210) 593-9863
- NPI assigned
- Jul 26, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 00835 | IA | Primary |
Addresses
Primary practice location
7272 Wurzbach Rd
601
San Antonio, TX 78240-4801
Mailing address
7272 Wurzbach Rd
601
San Antonio, TX 78240-4801
Phone (210) 615-3483
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00835 | Other | IA | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
407 S E Ave
Baxter, IA 50028-1013
Phone (641) 227-3602
4130 Northwest Blvd
Davenport, IA 52806-4243
Phone (563) 391-3430
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.16 of 100
- Quality
- 80.99
- Improvement activities
- 40
- Cost
- 72.05
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deer Oaks Mental Health Associates PC | Current | Accepting new patients |
Locations
407 S East Ave
Baxter, IA 50028
Phone (641) 227-3602
7272 Wurzbach Rd
Ste 601
San Antonio, TX 78240
Phone (210) 615-3472
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343260800000",
"number": "1235485301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7272 WURZBACH RD",
"address_2": "601",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782404801",
"telephone_number": "210-615-3483",
"fax_number": "210-593-9863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7272 WURZBACH RD",
"address_2": "601",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782404801",
"telephone_number": "210-615-3483",
"fax_number": "210-593-9863"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILDEN",
"first_name": "SUSAN",
"middle_name": "E",
"name_prefix": "Ms.",
"credential": "LISW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-26",
"last_updated": "2012-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IA",
"license": "00835",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "00835",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2012; 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.