Active NPI
Susan R Cordes, M.D.
- Otolaryngology Physician
- Stockton, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- G129761
- Practice address
- 10200 Trinity Pkwy Ste 201
Stockton, CA 95219-7288 - Phone
- (209) 952-0483
- Fax
- (209) 478-5785
- NPI assigned
- Jul 10, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 01043929A | IN | |
| Otolaryngology Physician | 207Y00000X | G129761 | CA | Primary |
Addresses
Primary practice location
10200 Trinity Pkwy Ste 201
Stockton, CA 95219-7288
Mailing address
1111 Exposition Blvd BLDG 700
Sacramento, CA 95815-4314
Phone (916) 736-3399
Other practice location 1
801 S Ham Ln Ste O
Lodi, CA 95242-7502
Phone (209) 952-0483
Other practice location 2
550 W Eaton Ave Ste 548
Tracy, CA 95376-3422
Phone (209) 952-0483
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200167750 | Medicaid | IN |
Other names 1
- Susan R Slakes
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10200 Trinity Pkwy
Suite 201
Stockton, CA 95219-7288
Phone (209) 952-0483
Hospital & facility affiliations
- St Joseph'S Medical Center of Stockton
- Adventist Health Lodi Memorial
- Sutter Tracy Community Hospital
- Sutter Amador Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 74.25 of 100
- Quality
- 51.19
- Promoting interoperability
- 94
- Improvement activities
- 40
- Cost
- 61.73
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G129761 | CA | MD | Otolaryngology Physician |
| 01043929A | IN | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sacramento Ear Nose & Throat Surgical & Medical Group Inc | Otolaryngology | Current | Accepting new patients |
| University Otolaryngology Associates, Inc. | Otolaryngology | Past | Accepting new patients |
| General Otorhinolaryngological Foundation, Inc. | Otolaryngology | Past | Accepting new patients |
| Major Hospital | Past | Accepting new patients |
Locations
801 S Ham Ln
Ste O
Lodi, CA 95242
Phone (209) 365-0526
1111 Exposition Blvd
Bldg 700
Sacramento, CA 95815
Phone (916) 736-3399
1111 Exposition Blvd
Ste 700
Sacramento, CA 95815
Phone (916) 736-3399
10200 Trinity Pkwy
Ste 201
Stockton, CA 95219
Phone (209) 952-0483
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- scordes219179@hisp.ehr.sutterhealth.org
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.
-
- Otolaryngology Physician
- Sacramento, CA
- NPI 1497758155
-
- Otolaryngology Physician
- Indianapolis, IN
- NPI 1992715452
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
-
- Otolaryngology Physician
- Indianapolis, IN
- NPI 1275563447
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Lodi, CA
- NPI 1316938301
-
- General Acute Care Hospital
- Stockton, CA
- NPI 1528190931
-
- General Acute Care Hospital
- Jackson, CA
- NPI 1447494323
-
- General Acute Care Hospital
- Tracy, CA
- NPI 1821442864
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593475200000",
"number": "1285668707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 EXPOSITION BLVD BLDG 700",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958154314",
"telephone_number": "916-736-3399",
"fax_number": "916-736-3350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10200 TRINITY PKWY STE 201",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952197288",
"telephone_number": "209-952-0483",
"fax_number": "209-478-5785"
}
],
"practiceLocations": [
{
"address_1": "801 S Ham Ln Ste O",
"address_purpose": "LOCATION",
"city": "Lodi",
"state": "CA",
"postal_code": "952427502",
"country_code": "US",
"telephone_number": "209-952-0483",
"fax_number": "209-478-5785",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "550 W Eaton Ave Ste 548",
"address_purpose": "LOCATION",
"city": "Tracy",
"state": "CA",
"postal_code": "953763422",
"country_code": "US",
"telephone_number": "209-952-0483",
"fax_number": "209-478-5785",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CORDES",
"first_name": "SUSAN",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-10",
"last_updated": "2020-06-30",
"certification_date": "2020-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "IN",
"license": "01043929A",
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "CA",
"license": "G129761",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200167750",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SUSAN",
"last_name": "SLAKES",
"middle_name": "R",
"credential": "M.D.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; 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.