Individual provider Active NPI

Susan K Daleiden, PT

  • Physical Therapist
  • Anchorage, AK
National Provider Identifier
1366577199
Registry record updated Oct 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1419 Issued in AK
Practice address
3417 Vassar Dr
Anchorage, AK 99508-4332
Phone
(907) 350-6156
NPI assigned
Feb 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1419 AK Primary

Addresses

Primary practice location

3417 Vassar Dr
Anchorage, AK 99508-4332

Mailing address

3417 Vassar Dr
Anchorage, AK 99508-4332
Phone (907) 350-6156

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

LicenseStateTypeSpecialty
1419AKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Physical Therapy Inc Physical Therapist PastSince Jan 1, 2006 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255478400000",
    "number": "1366577199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3417 VASSAR DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084332",
            "telephone_number": "907-350-6156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3417 VASSAR DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084332",
            "telephone_number": "907-350-6156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALEIDEN",
        "first_name": "SUSAN",
        "middle_name": "K",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2009-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "1419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.