Susan Marie Mahoney, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00034157 Issued in WA

Practice address

1117 Spring St
Friday Harbor, WA 98250-8057

Phone

(360) 378-2141

Fax

(360) 378-3655

NPI assigned

Aug 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smahoney4546@direct.peacehealth.org

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.

• Peacehealth

  • Critical Access Hospital
  • Friday Harbor, WA
  • NPI 1487917233
  Medicare reassignment NPD
• Peacehealth

  • Emergency Medicine Physician
  • Friday Harbor, WA
  • NPI 1508129842
  Medicare reassignment NPD
• San Juan County Public Hospital District No 1

  • Public Health or Welfare Agency
  • Friday Harbor, WA
  • NPI 1932159605
  NPD
• Peacehealth

  • Internal Medicine Physician
  • Bellingham, WA
  • NPI 1356309553

  Family Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359936000000",
    "number": "1295848265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5096",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982275096",
            "telephone_number": "360-378-2141",
            "fax_number": "360-378-3655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 SPRING ST",
            "city": "FRIDAY HARBOR",
            "state": "WA",
            "postal_code": "982508057",
            "telephone_number": "360-378-2141",
            "fax_number": "360-378-3655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2013-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MD00034157",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00034157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCY BLUE SHIELD",
            "identifier": "1295848265",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295848265",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8209199",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRI-WEST (TRICARE)",
            "identifier": "1295848265",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lavendera Day Spa LTD
• Lavendera Massage LLC
• Susan Lynn Lefever, PHYSICAL THERAPIST
• Patricia Baer Lehr, LICSW
• Karen Elizabeth Libby, RN,LMP
• Susan Cooper Marean, CDP
• Joshua Matlock, PHARMD
• C. Shahn McGuire, LMFT
• Michael T. Horn, DDS, PLLC
• Natalie Miller Nawn, LSWAIC

• Family Medicine Physician in Friday Harbor, WA
• Providers in Friday Harbor, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.