Individual provider Active NPI

Susan Stefanac Laubach, M.D.

  • Allergy & Immunology Physician
  • San Diego, CA
National Provider Identifier
1366656209
Registry record updated Mar 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
A114061 Issued in CA
Practice address
5776 Ruffin Rd
San Diego, CA 92123-1013
Phone
(858) 292-1144
Fax
(858) 268-5145
NPI assigned
May 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X A114061 CA Primary
Pediatrics Physician 208000000X A114061 CA

Addresses

Primary practice location

5776 Ruffin Rd
San Diego, CA 92123-1013

Mailing address

3020 Childrens Way
San Diego, CA 92123-4223
Phone (858) 309-6300

Other names 1

  • Susan Marie Stefanac Former name

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
I20111027000148 CA Practitioner - Pediatric MedicinePractitioner - Allergy/Immunology 6507046653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Allergy/Immunology
Education
University of California, San Francisco School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rady Children'S Hospital San DiegoGroup PAC ID 3971677493, 164 clinicians

Practice addresses (Care Compare)

2125 Citracado Pkwy
Escondido, CA 92029-4159
Phone (760) 294-9260

3010 Childrens Way
San Diego, CA 92123-4223
Phone (858) 576-1700

3020 Children'S Way
San Diego, CA 92123-4223
Phone (858) 576-1700

5776 Ruffin Rd
San Diego, CA 92123-1013
Phone (858) 576-1700

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rady Children'S Hospital San Diego Pediatrics CurrentSince Jun 25, 2014 Accepting new patients
Empower Allergy Treatment Current Accepting new patients
Rady Children'S Hospital San Diego Allergy & Immunology CurrentSince Jun 25, 2014 Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Scripps Health Past Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation Past Accepting new patients

Locations

2125 Citracado Pkwy
Ste 200
Escondido, CA 92029
Phone (760) 294-9270

25170 Hancock Ave
Murrieta, CA 92562
Phone (858) 757-3277

5776 Ruffin Rd
San Diego, CA 92123
Phone (858) 292-1144

3020 Childrens Way
#5069
San Diego, CA 92123
Phone (858) 966-5911

3020 Childrens Way
San Diego, CA 92123
Phone (858) 966-5841

3020 Childrens Way
#5114
San Diego, CA 92123

Interoperability endpoints

  • Direct secure messaging: slaubach94562@radychildrens.direct-ci.com

Organizations & group practices 6

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": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458000000000",
    "number": "1366656209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-309-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5776 RUFFIN RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231013",
            "telephone_number": "858-292-1144",
            "fax_number": "858-268-5145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUBACH",
        "first_name": "SUSAN",
        "middle_name": "STEFANAC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2016-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "CA",
            "license": "A114061",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A114061",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "STEFANAC",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.