Individual provider Active NPI

Susan Briones, MD

  • Family Medicine Physician
  • Chandler, AZ
National Provider Identifier
1275684284
Registry record updated Oct 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22101 Issued in AZ
Practice address
1455 W Chandler Blvd
Ste. B-11
Chandler, AZ 85224-6177
Phone
(480) 917-9208
Fax
(480) 814-7443
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2015

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 22101 AZ Primary

Addresses

Primary practice location

1455 W Chandler Blvd
Ste. B-11
Chandler, AZ 85224-6177

Mailing address

1455 W Chandler Blvd
Ste. B-11
Chandler, AZ 85224-6177
Phone (480) 917-9208

Other identifiers 1

IdentifierTypeStateIssuer
178815MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20200305000334 TX Practitioner - Family Practice 6103720917 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gila River Health Care CurrentSince Dec 23, 2019 Accepting new patients
Gila River Health Care Corporation Current Accepting new patients
Gila River Health Care CurrentSince Dec 23, 2019 Accepting new patients
Gila River Health Care Corporation Current Accepting new patients

Locations

17487 S Healthcare Dr
Laveen, AZ 85339
Phone (520) 550-6000

17487 S Healthcare Dr
#H
Laveen, AZ 85339
Phone (520) 550-6000

48203 W Farrell Rd
Maricopa, AZ 85139
Phone (520) 568-3881

48203 W Farrell Rd
#H
Maricopa, AZ 85139
Phone (520) 568-3881

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": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445299200000",
    "number": "1275684284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 W CHANDLER BLVD",
            "address_2": "STE. B-11",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852246177",
            "telephone_number": "480-917-9208",
            "fax_number": "480-814-7443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 W CHANDLER BLVD",
            "address_2": "STE. B-11",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852246177",
            "telephone_number": "480-917-9208",
            "fax_number": "480-814-7443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIONES",
        "first_name": "SUSAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2015-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "22101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178815",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.