Active NPI
Susan E Soares, MSW, LCSW
- Clinical Social Worker
- Indianapolis, IN
National Provider Identifier
1447550272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34006853A
- Practice address
- 5638 Professional Cir
Indianapolis, IN 46241-5042 - Phone
- (317) 247-8900
- Fax
- (317) 247-8935
- NPI assigned
- Oct 27, 2010
- Reactivated
- Feb 26, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 34006853A | IN | Primary |
Addresses
Primary practice location
5638 Professional Cir
Indianapolis, IN 46241-5042
Mailing address
5638 Professional Cir
Indianapolis, IN 46241-5042
Phone (317) 247-8900
Other names 1
- Susan Hunter
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Indiana Medical College, School of Medicine of Purdue University, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
8398 Mississippi St
FL 2
Merrillville, IN 46410-6316
Phone (855) 743-2247
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34006853A | IN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Extended Care Specialists, Inc | Clinical | Current | Accepting new patients |
Locations
3512 Stellhorn Rd
Fort Wayne, IN 46815
8398 Mississippi St
Fl 2
Merrillville, IN 46410
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": "1288137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393372800000",
"number": "1447550272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5638 PROFESSIONAL CIR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462415042",
"telephone_number": "317-247-8900",
"fax_number": "317-247-8935"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5638 PROFESSIONAL CIR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462415042",
"telephone_number": "317-247-8900",
"fax_number": "317-247-8935"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOARES",
"first_name": "SUSAN",
"middle_name": "E",
"credential": "MSW, LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-27",
"last_updated": "2014-02-26",
"deactivation_date": "2013-12-11",
"reactivation_date": "2014-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34006853A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SUSAN",
"last_name": "HUNTER",
"credential": "MSW",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.