Individual provider Active NPI

Susan Ann Bidigare, M.D.

  • Family Medicine Physician
  • Woodbury, NJ
National Provider Identifier
1396737342
Registry record updated Feb 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301065479 Issued in MI
Practice address
190 N Evergreen Ave
Ste 204
Woodbury, NJ 08096-1862
Phone
(856) 853-8414
NPI assigned
Aug 16, 2005
Last updated
Feb 22, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301065479 MI Primary

Addresses

Primary practice location

190 N Evergreen Ave
Ste 204
Woodbury, NJ 08096-1862

Mailing address

190 N Evergreen Ave
Ste 204
Woodbury, NJ 08096-1862
Phone (856) 853-8414

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
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
American Current Care of Michigan PC CurrentSince Jul 28, 2012 Accepting new patients
American Current Care of Michigan PC Current Accepting new patients
Emergency Care Services of New Jersey, PA Past Accepting new patients

Locations

33089 Groesbeck Hwy
Fraser, MI 48026
Phone (586) 296-2800

436 44th St SE
Ste A
Kentwood, MI 49548
Phone (616) 531-9750

11569 E 12 Mile Rd
Warren, MI 48093
Phone (586) 582-0018

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266796800000",
    "number": "1396737342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 N EVERGREEN AVE",
            "address_2": "STE 204",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080961862",
            "telephone_number": "856-853-8414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 N EVERGREEN AVE",
            "address_2": "STE 204",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080961862",
            "telephone_number": "856-853-8414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIDIGARE",
        "first_name": "SUSAN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2010-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301065479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NJ

Sources for this page

Verify at the official NPI Registry.