Individual provider Active NPI

Sean Ross Sussman, DO

  • Family Medicine Physician
  • Swedesboro, NJ
National Provider Identifier
1316468895
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB10777400 Issued in NJ
Practice address
40 Village Green Dr Ste B
Swedesboro, NJ 08085-3253
Phone
(856) 467-7360
Fax
(856) 467-5959
NPI assigned
Jul 5, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MB10777400 NJ Primary

Addresses

Primary practice location

40 Village Green Dr Ste B
Swedesboro, NJ 08085-3253

Mailing address

40 Village Green Dr Ste B
Swedesboro, NJ 08085-3253
Phone (856) 467-7360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20200629002008 NJ Practitioner - Internal Medicine 6901228501 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inspira Health Network Medical Group PCGroup PAC ID 4880797570, 238 clinicians

Practice addresses (Care Compare)

40 Village Green Dr
Suite B
Swedesboro, NJ 08085-3251
Phone (856) 467-7360

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Inspira Health Network Medical Group, P.C. CurrentSince Aug 1, 2022 Accepting new patients
Inspira Health Network Urgent Care, P.C. CurrentSince Jul 1, 2020 Accepting new patients
Inspira Medical Centers, Inc. Past Accepting new patients
South Jersey Urgicare LLC PastSince Jul 1, 2014 Accepting new patients

Locations

1120 Delsea Dr N
Glassboro, NJ 08028
Phone (856) 205-7071

200 Rowan Blvd
Glassboro, NJ 08028
Phone (856) 582-0500

798 Centerton Rd
Pittsgrove, NJ 08318
Phone (856) 358-6161

40 Village Green Dr
Ste B
Swedesboro, NJ 08085
Phone (856) 467-7360

17 W Red Bank Ave
Ste 104
Woodbury, NJ 08096
Phone (856) 848-0665

40 Village Green Dr
Woolwich Twp, NJ 08085
Phone (856) 223-8930

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1499212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1316468895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 VILLAGE GREEN DR STE B",
            "city": "SWEDESBORO",
            "state": "NJ",
            "postal_code": "080853253",
            "telephone_number": "856-467-7360",
            "fax_number": "856-467-5959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 VILLAGE GREEN DR STE B",
            "city": "SWEDESBORO",
            "state": "NJ",
            "postal_code": "080853253",
            "telephone_number": "856-467-7360",
            "fax_number": "856-467-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSSMAN",
        "first_name": "SEAN",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-05",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB10777400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Swedesboro, NJ

Sources for this page

Verify at the official NPI Registry.