Individual provider Active NPI

Susan Elaine Wittenberg, MD

  • Ophthalmology Physician
  • Houston, TX
National Provider Identifier
1437194396
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
M2501 Issued in TX
Practice address
2855 Gramercy St
Houston, TX 77025
Phone
(713) 668-6828
NPI assigned
Jun 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Uveitis and Ocular Inflammatory Disease (Ophthalmology) Physician 207WX0108X M2501 TX
Ophthalmology Physician 207W00000X M2501 TX Primary

Addresses

Primary practice location

2855 Gramercy St
Houston, TX 77025

Mailing address

2855 Gramercy St # 400
Houston, TX 77025-1697
Phone (713) 668-6828

Other identifiers 1

IdentifierTypeStateIssuer
179164202MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address susanwittenberg@houstoneye.direct.eyemdemr.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M2501TXMDUveitis and Ocular Inflammatory Disease (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Eye Associates Ophthalmology Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: susanwittenberg@houstoneye.direct.eyemdemr.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1437194396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2855 GRAMERCY ST # 400",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770251697",
            "telephone_number": "713-668-6828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 GRAMERCY ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77025",
            "telephone_number": "713-668-6828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTENBERG",
        "first_name": "SUSAN",
        "middle_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0108X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Uveitis and Ocular Inflammatory Disease",
            "state": "TX",
            "license": "M2501",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "M2501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179164202",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "susanwittenberg@houstoneye.direct.eyemdemr.com",
            "affiliation": "N",
            "endpointDescription": "direct message address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2855 Gramercy St",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "77025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.