Individual provider Active NPI

Susan Woodmansee, M.D

  • Emergency Medicine Physician
  • Antioch, CA
National Provider Identifier
1275552580
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A55503 Issued in CA
Practice address
3901 Lone Tree Way
Antioch, CA 94509-6200
Phone
(925) 779-7273
NPI assigned
Jul 18, 2006
Last updated
Feb 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A55503 CA Primary

Addresses

Primary practice location

3901 Lone Tree Way
Antioch, CA 94509-6200

Mailing address

2100 Powell St
Ste 920
Emeryville, CA 94608-1826
Phone (510) 350-2777

Other practice location 1

2823 Fresno St
Fresno, CA 93721-1324
Phone (559) 499-6440

Other identifiers 1

IdentifierTypeStateIssuer
00A555030MedicaidCA

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
I20070530000590 CA Practitioner - Emergency Medicine 0042318958 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Baylor College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - CaliforniaGroup PAC ID 6103739131, 1,278 clinicians

Practice addresses (Care Compare)

2540 E St
Concord, CA 94520-1906
Phone (929) 682-8200

2823 Fresno St
Fresno, CA 93721-1324
Phone (559) 459-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as group
Quality
76.71
Promoting interoperability
100
Improvement activities
40
Cost
74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A55503CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine Current Accepting new patients
University Faculty Associates, Inc. CurrentSince May 16, 2015 Accepting new patients
Cep America - Auc PC CurrentSince Sep 1, 2014 Accepting new patients
University Faculty Associates, Inc. Emergency Medicine CurrentSince May 16, 2015 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Aug 1, 2001 Accepting new patients
Cep America - Auc PC CurrentSince Sep 1, 2014 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Aug 1, 2001 Accepting new patients
Fresno Community Hospital and Medical Center Past Accepting new patients
Regional Emergency Medical Group Inc Emergency Medicine Past Accepting new patients
Saint Agnes Medical Center Past Accepting new patients
John Muir Health Past Accepting new patients
Community Hospitalist Medical Group Inc. Past Accepting new patients
Hanford Community Hospital Past Accepting new patients

Locations

3901 Lone Tree Way
Antioch, CA 94509
Phone (925) 779-7200

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

2540 East St
Concord, CA 94520
Phone (925) 674-2228

2335 E Kashian Ln
Ste 240
Fresno, CA 93701
Phone (559) 320-0545

2823 Fresno St
Fresno, CA 93721
Phone (559) 459-3965

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 2

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1275552580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "STE 920",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 LONE TREE WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945096200",
            "telephone_number": "925-779-7273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2823 Fresno St",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937211324",
            "country_code": "US",
            "telephone_number": "559-499-6440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODMANSEE",
        "first_name": "SUSAN",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A55503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A555030",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, CA

Sources for this page

Verify at the official NPI Registry.