Susan Denise Stukes, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

041240 Issued in NY

Practice address

8127 Stenton Ave
Philadelphia, PA 19150

Phone

(267) 331-9832

NPI assigned

Oct 29, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dentist

Education

Howard University College of Dentistry, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Covenant House IncGroup PAC ID 3476591686, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: susan.stukes.p1@direct.covenanthousehealth.nextgenshare.com

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Covenant House Inc

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1659462679

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Covenant House Inc

  • Pediatrics Physician
  • Philadelphia, PA
  • NPI 1669177911

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Covenant House Inc

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1699190561

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Covenant House, Inc

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1528392008

  Corporate Officer, W-2 Managing Employee

  CMS ownership

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.

• Covenant House Inc

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1659462679
  Medicare reassignment Care Compare group NPD Authorized official
• Covenant House Inc

  • Pediatrics Physician
  • Philadelphia, PA
  • NPI 1669177911
  NPD Authorized official
• Covenant House Inc

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1699190561
  NPD (past) Authorized official

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

{
    "created_epoch": "1288310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547510400000",
    "number": "1306146923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8127 STENTON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191503530",
            "telephone_number": "267-331-9832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8127 STENTON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19150",
            "telephone_number": "267-331-9832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUKES",
        "first_name": "SUSAN",
        "middle_name": "DENISE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-29",
        "last_updated": "2019-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "041240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James S. Studdiford III, M.D.
• Student Health Service, University of Pennsylvania
• Jeffrey Thomas Student, MD
• William Reece Studt
• Bernard John Stuetz, P.A.-C
• Eric Lee Stulberg, MD
• Carolyn Stull, MD
• Elizabeth Tatiana Stulpin, MD
• Gabriel Clark Stump, PA-C
• Jennifer Stundon, MD, PHD

• Dentist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.