Susanna O Buchholz, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME90657 Issued in FL

Practice address

91 Mack Bayou Loop
Santa Rosa Beach, FL 32459-2604

Phone

(850) 659-6556

NPI assigned

Sep 9, 2005

Last updated

Nov 18, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Pediatric Medicine

Education

University of Florida College of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bridgeway Center, IncGroup PAC ID 0446153084, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14223/brand/1/csg/1/fhir/r4
• Direct secure messaging: susanna.buchholz.1@14223.direct.athenahealth.com
• Direct secure messaging: susanna.buchholz.1@20976.direct.athenahealth.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.

• Bridgeway Center Inc

  • Community/Behavioral Health Agency
  • Fort Walton Beach, FL
  • NPI 1578677076
  Medicare reassignment Care Compare group NPD
• Bridgeway Center, Inc

  • General Practice Physician
  • Fort Walton Beach, FL
  • NPI 1174169080
  NPD
• Coastal Pediatric Group

  • Pediatrics Physician
  • Destin, FL
  • NPI 1417304643
  NPD (past)
• Pensacola Primary Care Inc

  • Family Medicine Physician
  • Pensacola, FL
  • NPI 1982643169

  Pediatrics

  NPD (past)
• Privia Medical Group Florida, LLC

  • General Practice Physician
  • Indialantic, FL
  • NPI 1700649043
  NPD (past)

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1386638864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 MACK BAYOU LOOP",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324592604",
            "telephone_number": "850-659-6556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 MACK BAYOU LOOP",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324592604",
            "telephone_number": "850-659-6556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCHHOLZ",
        "first_name": "SUSANNA",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-09",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME90657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Layne Boyce King, DDS
• Mark A Braasch, DDS
• Rhea Bradford, RN
• April Nicole Bradley, L.AC., AP
• Laura Ann Bruck-Hillas, APRN
• Jared M Bump, DO
• Donna S Burgett
• Madison Butcher
• Faith Ava Campbell Powers, LMFT
• Sarah Canterbury

• Pediatrics Physician in Santa Rosa Beach, FL
• Providers in Santa Rosa Beach, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; 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.