Individual provider Active NPI

Susan M Stasiewicz

  • Anesthesiology Physician
  • Washington, DC
National Provider Identifier
1376566950
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD19725 Issued in DC
Practice address
110 Irving St NW
Washington, DC 20010-2976
Phone
(301) 946-5100
Fax
(301) 929-0348
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD19725 DC Primary

Addresses

Primary practice location

110 Irving St NW
Washington, DC 20010-2976

Mailing address

11510 Georgia Ave
Suite 206
Wheaton, MD 20902-1925
Phone (301) 946-5100

Other identifiers 8

IdentifierTypeStateIssuer
0057OtherDCCAREFIRST BCBS
4296001OtherDCAETNA NON HMO
501354OtherDCNCPPO
5261427OtherDCCCN NETWORK
5705282MedicaidVA
102696OtherDCKAISER
2494486OtherDCAETNA HMO
441061OtherVAANTHEM BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
WHC Physician Group LLC CurrentSince Mar 27, 2013 Accepting new patients
Medstar Medical Group Anesthesiology LLC Anesthesiology CurrentSince Jun 1, 2018 Accepting new patients
Medstar Medical Group Anesthesiology LLC Anesthesiology CurrentSince Jun 1, 2018 Accepting new patients
WHC Emerg Phys CurrentSince Mar 27, 2013 Accepting new patients
Washington Hospital Center Corp Anesthesiology Past Accepting new patients

Locations

110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000

7503 Surratts Rd
Clinton, MD 20735
Phone (301) 868-8000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1376566950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11510 GEORGIA AVE",
            "address_2": "SUITE 206",
            "city": "WHEATON",
            "state": "MD",
            "postal_code": "209021925",
            "telephone_number": "301-946-5100",
            "fax_number": "301-929-0348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 IRVING ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102976",
            "telephone_number": "301-946-5100",
            "fax_number": "301-929-0348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STASIEWICZ",
        "first_name": "SUSAN",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "DC",
            "license": "MD19725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "0057",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA NON HMO",
            "identifier": "4296001",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPPO",
            "identifier": "501354",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCN NETWORK",
            "identifier": "5261427",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5705282",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "102696",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2494486",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "441061",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.