Active NPI
Susan M Dugo, PT
- Physical Therapist
- Sun City West, AZ
National Provider Identifier
1306845383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 0892
- Practice address
- 14506 W Granite Valley Dr
#205
Sun City West, AZ 85375-6010 - Phone
- (623) 584-5626
- Fax
- (623) 584-8998
- NPI assigned
- Jul 20, 2005
- Last updated
- Oct 19, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 0892 | AZ | Primary |
Addresses
Primary practice location
14506 W Granite Valley Dr
#205
Sun City West, AZ 85375-6010
Mailing address
14506 W Granite Valley Dr
#205
Sun City West, AZ 85375-6010
Phone (623) 584-5626
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CN1748 | Other | AZ | RAILROAD MEDICARE |
| P00298983 | Other | AZ | RAILROAD MEDICARE |
| P0298960 | Other | AZ | BC/BS AZ |
| 780454 | Other | AZ | AHCCCS |
| 2Z4613 | Other | HEALTH NET | |
| 895056 | Other | AZ | UNITED HEALTHCARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0892 | AZ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192752000000",
"number": "1306845383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14506 W GRANITE VALLEY DR",
"address_2": "#205",
"city": "SUN CITY WEST",
"state": "AZ",
"postal_code": "853756010",
"telephone_number": "623-584-5626",
"fax_number": "623-584-8998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14506 W GRANITE VALLEY DR",
"address_2": "#205",
"city": "SUN CITY WEST",
"state": "AZ",
"postal_code": "853756010",
"telephone_number": "623-584-5626",
"fax_number": "623-584-8998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUGO",
"first_name": "SUSAN",
"middle_name": "M",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-20",
"last_updated": "2007-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "0892",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CN1748",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00298983",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS AZ",
"identifier": "P0298960",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AHCCCS",
"identifier": "780454",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET",
"identifier": "2Z4613",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "895056",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sun City West, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.