Mitchell Sussman, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

036088537 Issued in IL

Practice address

611 W. Park St.
Radiology
Urbana, IL 61801

Phone

(217) 383-3270

Fax

(217) 383-4116

NPI assigned

Jun 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

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

Diagnostic Radiology

Education

Albany Medical College of Union University, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hoopeston Community Memorial HospitalGroup PAC ID 3577456037, shared by 11 NPIs, 142 clinicians

Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Richland Memorial Hospital IncGroup PAC ID 3870565732, 107 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carle Foundation Hospital Hospital, Urbana, IL, CCN 140091
• Carle Hoopeston Regional Health Center Hospital, Hoopeston, IL, CCN 141316

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: msussmanmd97242@carlehiedirect.net

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.

• Carle Health Care Incorporated

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  Medicare reassignment Care Compare group NPD
• Richland Memorial Hospital, Inc

  • Critical Access Hospital
  • Olney, IL
  • NPI 1467492124
  Medicare reassignment Care Compare group NPD
• Hoopeston Community Memorial Hospital

  • Internal Medicine Physician
  • Hoopeston, IL
  • NPI 1043683014
  Medicare reassignment NPD
• Hoopeston Community Memorial Hospital

  • Critical Access Hospital
  • Hoopeston, IL
  • NPI 1366480873
  Medicare reassignment NPD
• Hoopeston Community Memorial Hospital

  • Rural Health Clinic/Center
  • Hoopeston, IL
  • NPI 1578504544
  NPD
• Richland Memorial Hospital, Inc

  • Rural Health Clinic/Center
  • Olney, IL
  • NPI 1326566290
  NPD
• Richland Memorial Hospital, Inc

  • Otolaryngology Physician
  • Olney, IL
  • NPI 1700063179
  NPD
• Radiology Imaging Specialists

  • Diagnostic Radiology Physician
  • Evergreen Park, IL
  • NPI 1861408213
  NPD (past)

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

• Carle Surgicenter

  • Ambulatory Surgical Clinic/Center
  • Danville, IL
  • NPI 1225194533

  Hospital

  Care Compare affiliation
• Hoopeston Community Memorial Hospital

  • Ambulance
  • Hoopeston, IL
  • NPI 1164594594

  Hospital

  Care Compare affiliation
• Hoopeston Community Memorial Hospital

  • Critical Access Hospital
  • Hoopeston, IL
  • NPI 1366480873
  Care Compare affiliation
• The Carle Foundation Hospital

  • General Acute Care Hospital
  • Urbana, IL
  • NPI 1013071653
  Care Compare affiliation

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400025600000",
    "number": "1427097104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST.",
            "address_2": "BWPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012500",
            "telephone_number": "217-383-6792",
            "fax_number": "217-383-4752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST.",
            "address_2": "RADIOLOGY",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61801",
            "telephone_number": "217-383-3270",
            "fax_number": "217-383-4116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSSMAN",
        "first_name": "MITCHELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2014-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "36088537",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036088537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036088537*3",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0533210001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cindy Renee Sundeen, APN
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• Suren Chiu Nutrition LLC
• Thomas L Sutter, D.O.
• Amanpreet Swaich, M.D.
• Harshil Yogesh Swaminarayan, M.D.
• Jeffrey V Swearingen, MD
• Kevin Sweeny, CRNA

• Diagnostic Radiology Physician in Urbana, IL
• Providers in Urbana, IL by specialty
• Diagnostic Radiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2014; 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.