Individual provider Active NPI

Susan B Dorsey, M.D.

  • Specialist
  • Roanoke, VA
National Provider Identifier
1457308371
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0101049876 Issued in VA
Practice address
1215 3Rd St SW
Roanoke, VA 24016-4611
Phone
(540) 981-1439
NPI assigned
May 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0101049876 VA Primary

Addresses

Primary practice location

1215 3Rd St SW
Roanoke, VA 24016-4611

Mailing address

1215 3Rd St SW
Roanoke, VA 24016-4611
Phone (540) 981-1439

Other identifiers 2

IdentifierTypeStateIssuer
005940583MedicaidVA
242781OtherVAANTHEM VA PROVIDER NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sdorsey19823@direct.carilionclinic.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20111119000029 VA Practitioner - Dermatology 5991979411 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Arkansas College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Healthcare CorporationGroup PAC ID 5890607253, 540 clinicians

Practice addresses (Care Compare)

1204 Franklin Rd SW
Roanoke, VA 24016-4606
Phone (540) 981-1439

Hospital & facility affiliations

  • Carilion Medical Center Hospital, Roanoke, VA, CCN 490024

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision82
Removal of skin lesions343
Removal or shaving of skin growth1-10
Skin biopsy540

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101049876VAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Healthcare Corporation CurrentSince Feb 19, 2018 Accepting new patients
Carilion Healthcare Corporation CurrentSince Feb 19, 2018 Accepting new patients
Carilion Medical Center CurrentSince Jun 1, 2018 Accepting new patients
Carilion Medical Center CurrentSince Jun 1, 2018 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1204 Franklin Rd SW
Roanoke, VA 24016
Phone (540) 345-6010

213 S Jefferson St
Ste 625
Roanoke, VA 24011
Phone (540) 224-5677

1906 Belleview Ave SE
Roanoke, VA 24014
Phone (540) 853-0222

6415 Peters Creek Rd
Roanoke, VA 24019
Phone (703) 562-2110

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1457308371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 3RD ST SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164611",
            "telephone_number": "540-981-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 3RD ST SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164611",
            "telephone_number": "540-981-1439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORSEY",
        "first_name": "SUSAN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-27",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101049876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005940583",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM VA PROVIDER NUMBER",
            "identifier": "242781",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sdorsey19823@direct.carilionclinic.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "sdorsey19823@direct.carilionclinic.org",
            "address_1": "1215 3rd St SW",
            "city": "Roanoke",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240164611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.