Susan Rae, M.D

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MA06609700 Issued in NJ

Practice address

1031 McBride Ave
Suite 210 D
Woodland Park, NJ 07424-2559

Phone

(973) 812-9091

Fax

(973) 339-9040

NPI assigned

Jul 17, 2005

Last updated

Feb 9, 2012By 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 5

Other names 1

• Sawsan Ali Former name

Medicare fee-for-service enrollment

Enrolled in NJ

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

Family Practice

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Medical Associates of Englewood PCGroup PAC ID 1355512252, 538 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045
• St Joseph's University Medical Center Inc Hospital, Paterson, NJ, CCN 310019

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: srae248504@direct.englewoodhealth.org

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.

• Medical Associates of Englewood, PC

  • Internal Medicine Physician
  • Englewood, NJ
  • NPI 1952681918
  Medicare reassignment Care Compare group NPD
• Suburban Family Medicine LLC

  • Primary Care Clinic/Center
  • Woodland Park, NJ
  • NPI 1982035093
  NPD (past) Authorized official
• Primary Care Medical Practice, LLC

  • Specialist
  • Woodland Park, NJ
  • NPI 1912113002
  NPD (past)

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

• Englewood Hospital and Medical Center

  • General Acute Care Hospital
  • Englewood, NJ
  • NPI 1083612881
  Care Compare affiliation
• St Josephs University Medical Center Inc.

  • General Acute Care Hospital
  • Paterson, NJ
  • NPI 1669462420
  Care Compare affiliation

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

{
    "created_epoch": "1121558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328745600000",
    "number": "1437158094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 MICHELLE WAY",
            "city": "PINE BROOK",
            "state": "NJ",
            "postal_code": "070589446",
            "telephone_number": "973-812-9091",
            "fax_number": "973-237-9053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 MCBRIDE AVE",
            "address_2": "SUITE 210 D",
            "city": "WOODLAND PARK",
            "state": "NJ",
            "postal_code": "074242559",
            "telephone_number": "973-812-9091",
            "fax_number": "973-339-9040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAE",
        "first_name": "SUSAN",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-17",
        "last_updated": "2012-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA06609700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00075820",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET HMO",
            "identifier": "2K4791",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE HMO",
            "identifier": "01000576801",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH HMO",
            "identifier": "60005903",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8777209",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAWSAN",
            "last_name": "ALI",
            "credential": "M.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Josafin Picarelli, DC
• Prestige of Woodland Park Amdc, LLC
• Primary Care Medical Practice, LLC
• Prompt Transportation Services LLC
• Rose Pszonka, RPH, PHARMD
• Pamela Ragaie
• Payal P. Ramakrishnan, OD
• Mannan Razzak, M.D.
• Nadia Mohsin Razzak, MD
• Betsey Rene, PT, DPT

• Family Medicine Physician in Woodland Park, NJ
• Providers in Woodland Park, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; 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.