Individual provider Active NPI

Susan Angerholzer Overton, P.A.

  • Surgical Physician Assistant
  • Mobile, AL
National Provider Identifier
1396994521
Registry record updated Jan 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
TA 1674 Issued in AL
Practice address
1901 Springhill Ave
Mobile, AL 36607-2303
Phone
(251) 300-2240
Fax
(251) 300-2249
NPI assigned
Sep 11, 2008
Last updated
Jan 29, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA.613 AL
Surgical Physician Assistant 363AS0400X TA 1674 AL Primary

Addresses

Primary practice location

1901 Springhill Ave
Mobile, AL 36607-2303

Mailing address

1855 Spring Hill Ave
Mobile, AL 36607-2301
Phone (251) 471-3544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20090109000456 AL Practitioner - Physician Assistant 3476616996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Imc-Cardio-Thoracic and Vascular Surgical Associates LLCGroup PAC ID 4981936796, 23 clinicians

Practice addresses (Care Compare)

1770 N Alston St
Foley, AL 36535-2274
Phone (251) 471-3544

5 Mobile Infirmary Cir
Mobile, AL 36607-3513

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.5 of 100Reported as group
Promoting interoperability
90
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.613ALMDSurgical Physician Assistant
TA 1674ALMDSurgical Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1221091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548720000000",
    "number": "1396994521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 SPRING HILL AVE",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366072301",
            "telephone_number": "251-471-3544",
            "fax_number": "251-471-3544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 SPRINGHILL AVE",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366072303",
            "telephone_number": "251-300-2240",
            "fax_number": "251-300-2249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERTON",
        "first_name": "SUSAN",
        "middle_name": "ANGERHOLZER",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-11",
        "last_updated": "2019-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AL",
            "license": "PA.613",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AL",
            "license": "TA 1674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.