Active NPI
Renee Susko, M.D.
- Family Medicine Physician
- Detroit, MI
National Provider Identifier
1376585810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 4301081513
- Practice address
- 5555 Conner St Ste 2818
Detroit, MI 48213-3448 - Phone
- (313) 264-6490
- NPI assigned
- Jun 11, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4301081513 | MI | Primary |
Addresses
Primary practice location
5555 Conner St Ste 2818
Detroit, MI 48213-3448
Mailing address
5555 Conner St Ste 2818
Detroit, MI 48213-3448
Phone (313) 264-6490
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: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 1, 2023 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- rsusko1154937@direct.hfhs.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744329600000",
"number": "1376585810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5555 CONNER ST STE 2818",
"city": "DETROIT",
"state": "MI",
"postal_code": "482133448",
"telephone_number": "313-264-6490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5555 CONNER ST STE 2818",
"city": "DETROIT",
"state": "MI",
"postal_code": "482133448",
"telephone_number": "313-264-6490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUSKO",
"first_name": "RENEE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-11",
"last_updated": "2025-04-11",
"certification_date": "2025-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "4301081513",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.