Individual provider Active NPI

Susan L Edelman, MD

  • Psychiatry Physician
  • Palo Alto, CA
National Provider Identifier
1336262518
Registry record updated Aug 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
C41752 Issued in CA
Practice address
451 Lytton Ave
Palo Alto, CA 94301-1535
Phone
(650) 325-2781
NPI assigned
Apr 10, 2007
Last updated
Aug 28, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X C41752 CA Primary

Addresses

Primary practice location

451 Lytton Ave
Palo Alto, CA 94301-1535

Mailing address

451 Lytton Ave
Palo Alto, CA 94301-1535
Phone (650) 325-2781

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20050309001064 CA Practitioner - Psychiatry 6406800630 Practice locations: Palo Alto, CA

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Louisiana State University School of Medicine in New Orleans, 1981
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

518 Byron St
Palo Alto, CA 94301-2006
Phone (650) 325-2781

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C41752CAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440720000000",
    "number": "1336262518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 LYTTON AVE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943011535",
            "telephone_number": "650-325-2781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 LYTTON AVE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943011535",
            "telephone_number": "650-325-2781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDELMAN",
        "first_name": "SUSAN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2015-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C41752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.