Individual provider Active NPI

Susan L Stefanski, NP-C

  • Nurse Practitioner
  • Gloucester, MA
National Provider Identifier
1376595264
Registry record updated Dec 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
163733 Issued in MA
Practice address
298 Washington Street
Lahey Cardiology, Gloucester
Gloucester, MA 01930
Phone
(978) 281-1500
Fax
(978) 381-7749
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 163733 MA Primary

Addresses

Primary practice location

298 Washington Street
Lahey Cardiology, Gloucester
Gloucester, MA 01930

Mailing address

298 Washington Street
Lahey Cardiology, Gloucester
Gloucester, MA 01930
Phone (978) 281-1500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060119000220 MA Practitioner - Nurse Practitioner 6002872074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beth Israel Lahey Health Specialty Care, Inc.Group PAC ID 2365405024, 264 clinicians

Practice addresses (Care Compare)

298 Washington St
Gloucester, MA 01930-4832
Phone (978) 283-2726

41 Mall Rd
Burlington, MA 01805-0001
Phone (781) 744-8400

Hospital & facility affiliations

  • Northeast Hospital Corporation Hospital, Beverly, MA, CCN 220033
  • Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
163733MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Lahey Health Specialty Care, Inc. CurrentSince Oct 28, 2016 Accepting new patients

Locations

85 Herrick St
Beverly, MA 01915
Phone (978) 816-3700

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

298 Washington St
Gloucester, MA 01930
Phone (978) 283-4000

Interoperability endpoints

  • Direct secure messaging: sstefanski82864@direct.bilh.masshiway.net

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482796800000",
    "number": "1376595264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "298 WASHINGTON STREET",
            "address_2": "LAHEY CARDIOLOGY, GLOUCESTER",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "01930",
            "telephone_number": "978-281-1500",
            "fax_number": "978-381-7749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 WASHINGTON STREET",
            "address_2": "LAHEY CARDIOLOGY, GLOUCESTER",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "01930",
            "telephone_number": "978-281-1500",
            "fax_number": "978-381-7749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEFANSKI",
        "first_name": "SUSAN",
        "middle_name": "L",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2016-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "163733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloucester, MA

Sources for this page

Verify at the official NPI Registry.