Susan A Neilsen, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35065003 Issued in OH

Practice address

15900 Snow Rd
Brookpark, OH 44142-2859

Phone

(216) 365-0772

NPI assigned

Oct 27, 2006

Last updated

Jan 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 11

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sneilsen@direct.swgeneral.com

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.

• Lakewood Hospital Association

  • Family Medicine Physician
  • Lakewood, OH
  • NPI 1205933512
  NPD (past)
• Lakewood Hospital Association

  dba Lakewood Hospital

  • Pharmacy
  • Lakewood, OH
  • NPI 1386089670
  NPD (past)
• University Primary Care Practices Inc.

  • Durable Medical Equipment & Medical Supplies
  • Mentor, OH
  • NPI 1053405217
  NPD (past)
• Rina Roy MDPC

  dba Sunrise Family Medical Care

  • Internal Medicine Physician
  • Everett, WA
  • NPI 1972727402

  Family Medicine

  NPD (past)
• U.S. Healthworks Medical Group of Washington, PS

  • Urgent Care Clinic/Center
  • Valencia, CA
  • NPI 1407836208
  NPD (past)

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1447336946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15900 SNOW RD",
            "city": "BROOKPARK",
            "state": "OH",
            "postal_code": "441422859",
            "telephone_number": "216-265-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15900 SNOW RD",
            "city": "BROOKPARK",
            "state": "OH",
            "postal_code": "441422859",
            "telephone_number": "216-365-0772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEILSEN",
        "first_name": "SUSAN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35065003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "378646",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "340714684101",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0969966",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "196433",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "341542312098",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCHP",
            "identifier": "740117",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD CARE",
            "identifier": "P00448233",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000370582",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000380939",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCHP",
            "identifier": "740121",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARERR",
            "identifier": "P00368534",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Murar, LPN
• Julie Myers, PT
• Jennifer Napier
• National Seating & Mobility, Inc
• Melissa Marie Nawrocki, AGNP-C
• Neo Pet II, LLC
• North Coast Orthotics and Prosthetics Inc
• North Park Al Opco LLC (North Park Care Community)
• North Park Al Opco LLC (North Park Care Community)
• North Park Care Center LLC (North Park Care Center)

• Family Medicine Physician in Brookpark, OH
• Providers in Brookpark, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.