Individual provider Active NPI

Susan Felsenthal, MD

  • Internal Medicine Physician
  • Cudahy, WI
National Provider Identifier
1437264512
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
47419 Issued in WI
Practice address
5900 S Lake Dr
Cudahy, WI 53110
Phone
(414) 489-9000
NPI assigned
Aug 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 47419 WI Primary
Internal Medicine Physician 207R00000X 036-058049 IL

Addresses

Primary practice location

5900 S Lake Dr
Cudahy, WI 53110

Mailing address

3301 W Forest Home Ave
Milwaukee, WI 53215-2843
Phone (414) 647-6326

Other names 1

  • Susan Goldstein Doing business as

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100614000384 IL Practitioner - Internal Medicine 4385606664 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-058049ILMDInternal Medicine Physician
47419WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Lake CurrentSince Jun 24, 2019 Accepting new patients
County of Lake Current Accepting new patients
Aurora Health Care Metro, Inc. Past Accepting new patients
Waukegan Clinic Corp Internal Medicine Past Accepting new patients

Locations

2400 Belvidere Rd
Waukegan, IL 60085
Phone (847) 377-8400

3010 Grand Ave
Waukegan, IL 60085
Phone (847) 377-8296

Interoperability endpoints

  • Direct secure messaging: susan.felsenthal.p1@direct.lakecountyil.nextgenshare.com
  • FHIR API: https://api.platform.athenahealth.com/2069/brand/1/csg/29/fhir/r4

Organizations & group practices 4

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437264512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W FOREST HOME AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152843",
            "telephone_number": "414-647-6326",
            "fax_number": "414-671-8860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 S LAKE DR",
            "city": "CUDAHY",
            "state": "WI",
            "postal_code": "53110",
            "telephone_number": "414-489-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELSENTHAL",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "47419",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-058049",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "GOLDSTEIN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cudahy, WI

Sources for this page

Verify at the official NPI Registry.