Jonathan L Susa I, D.O.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

51842 Issued in WI

Practice address

2651 Hillcrest Drive
Hudson, WI 54016-4439

Phone

(715) 531-6800

Fax

(715) 531-6801

NPI assigned

Apr 16, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Obstetrics/Gynecology

Education

Arizona College of Osteopathic Medicine Mid Western University, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baldwin Area Medical Center IncGroup PAC ID 7911800586, 88 clinicians

Hudson Physicians SCGroup PAC ID 2668607557, 62 clinicians

Hudson Imaging Partners LLCGroup PAC ID 1557734225, 29 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Baldwin Area Medical Center, Inc.

  • Critical Access Hospital
  • Baldwin, WI
  • NPI 1467496133
  Medicare reassignment Care Compare group NPD
• Hudson Imaging Partners LLC

  • Diagnostic Radiology Physician
  • Hudson, WI
  • NPI 1346971371
  Medicare reassignment Care Compare group NPD
• Hudson Physicians, S.C.

  • Multi-Specialty Clinic/Center
  • Hudson, WI
  • NPI 1770916827
  Medicare reassignment Care Compare group
• Amery Regional Medical Center, Inc.

  • Critical Access Hospital
  • Amery, WI
  • NPI 1093763518
  Medicare reassignment
• Amery Regional Medical Center, Inc.

  • Rural Health Clinic/Center
  • Clear Lake, WI
  • NPI 1366878449
  NPD
• Amery Regional Medical Center, Inc.

  • Rural Health Clinic/Center
  • Luck, WI
  • NPI 1851345268
  NPD
• Baldwin Area Medical Center Inc.

  • Clinic/Center
  • Spring Valley, WI
  • NPI 1164272324
  NPD

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1295909752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2651 HILLCREST DRIVE",
            "address_2": "SUITE 303",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540164439",
            "telephone_number": "715-531-6800",
            "fax_number": "715-531-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2651 HILLCREST DRIVE",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540164439",
            "telephone_number": "715-531-6800",
            "fax_number": "715-531-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSA",
        "first_name": "JONATHAN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-16",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WI",
            "license": "51842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43549400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Amy Swanson, RDH
• Martha J Swanson, PTA
• Amy M Swenson
• Jessica Rae Tangen, IBCLC

• Obstetrics & Gynecology Physician in Hudson, WI
• Providers in Hudson, WI by specialty
• Obstetrics & Gynecology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; 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.

Verify at the official NPI Registry.