Susan A Nasri, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

01052481 Issued in IN

Practice address

5734 Coventry LN
Fort Wayne, IN 46804-7141

Phone

(260) 436-7875

Fax

(260) 432-9812

NPI assigned

Jul 12, 2005

Last updated

Nov 20, 2014By 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 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Northeast Indiana Anesthesiology, PC

  • Anesthesiology Physician
  • Columbia City, IN
  • NPI 1619917366
  NPD (past)
• University Medical Diagnostic Associates, Inc.

  • Internal Medicine Physician
  • Indianapolis, IN
  • NPI 1861441537
  NPD (past)

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416441600000",
    "number": "1457359598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2914 S REPUBLIC BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436151912",
            "telephone_number": "419-531-8808",
            "fax_number": "419-531-9342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5734 COVENTRY LN",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047141",
            "telephone_number": "260-436-7875",
            "fax_number": "260-432-9812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASRI",
        "first_name": "SUSAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2014-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01052481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCS",
            "identifier": "163856",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCS",
            "identifier": "163857",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "050087310",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCS",
            "identifier": "163855",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200357570",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crystal Nard
• Thayer Nasereddin, MD
• Chase Nash
• Leann Nash
• Imran Nasir, MD
• Mo'Ath Nassar, M.D
• Anjali Natarajan, MD
• National Home Health Care
• National Mentor Healthcare, LLC (Indiana MENTOR Adult Foster Care)
• National Mentor Healthcare, LLC (Indiana Mentor)

• Anesthesiology Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Anesthesiology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2014; 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.