Suzette Anderson, CRNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

R148987 Issued in MD

Practice address

Dr. Shafquat Meraj Mdpa
1015 Prince Frederick Blvd.
Prince Frederick, MD 20678

Phone

(410) 535-4116

NPI assigned

Sep 1, 2020

Last updated

Jan 24, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mdics Rehabilitative Services LLCGroup PAC ID 4981861903, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Calverthealth Medical Center Hospital, Prince Frederick, MD, CCN 210039

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: suzette.andersoncrnp.p2@direct.msmg.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mdics Rehabilitative Services LLC

  • Internal Medicine Physician
  • Glen Burnie, MD
  • NPI 1124313309

  DC

  Medicare reassignment Care Compare group NPD
• Mdics Rehabilitative Services - Ltcaco LLC

  • Internal Medicine Physician
  • La Plata, MD
  • NPI 1033005475

  DC

  Medicare reassignment NPD
• Mdics at Civista LLC

  • Hospitalist Physician
  • La Plata, MD
  • NPI 1225323496
  NPD
• Medstar Medical Group - Southern Maryland LLC

  • Ambulatory Surgical Clinic/Center
  • Waldorf, MD
  • NPI 1730571118
  NPD

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

• Calverthealth Medical Center, Inc.

  dba CalvertHealth Medical Center

  • General Acute Care Hospital
  • Prince Frederick, MD
  • NPI 1457389298
  Care Compare affiliation

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1386258929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 PRINCE FREDERICK BLVD",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206783193",
            "telephone_number": "410-535-4116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DR. SHAFQUAT MERAJ MDPA",
            "address_2": "1015 PRINCE FREDERICK BLVD.",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "20678",
            "telephone_number": "410-535-4116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Saint Patricks Dr",
            "address_purpose": "LOCATION",
            "city": "Waldorf",
            "state": "MD",
            "postal_code": "206034527",
            "country_code": "US",
            "telephone_number": "301-373-7900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1015 Prince Frederick Blvd",
            "address_purpose": "LOCATION",
            "city": "Prince Frederick",
            "state": "MD",
            "postal_code": "206783193",
            "country_code": "US",
            "telephone_number": "301-373-7900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "SUZETTE",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-01",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "R148987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184189100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UROLOGY",
            "identifier": "1386258929",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Danielle Anderson, LCPC
• Makenzie Andrus
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• Anesthesia Company, LLC
• Anesthesia Company, LLC
• Anesthesia Company, LLC

• Gerontology Nurse Practitioner in Prince Frederick, MD
• Providers in Prince Frederick, MD by specialty
• Gerontology Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.