Individual provider Active NPI

Suzanne Nielsen, M.D.

  • Pediatrics Physician
  • Gilbert, AZ
National Provider Identifier
1457526030
Registry record updated Dec 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
44898 Issued in AZ
Practice address
155 E Warner Rd
Gilbert, AZ 85296-3082
Phone
(480) 649-6600
Fax
(480) 649-6700
NPI assigned
Apr 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X C7-0004038 DE
Pediatrics Physician 208000000X MT193802 PA
Pediatrics Physician 208000000X 44898 AZ Primary

Addresses

Primary practice location

155 E Warner Rd
Gilbert, AZ 85296-3082

Mailing address

155 E Warner Rd
Gilbert, AZ 85296-3082
Phone (480) 649-6600

Other names 1

  • Suzanne Goldring Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20130508000310 AZ Practitioner - Pediatric Medicine 9537306782 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44898AZMDPediatrics Physician
C7-0004038DEMDPediatrics Physician
MT193802PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Childrens Banner Health Clinic LLC CurrentSince Mar 1, 2020 Accepting new patients
Banner Childrens Banner Health Clinic LLC CurrentSince Mar 1, 2020 Accepting new patients

Locations

155 E Warner Rd
Gilbert, AZ 85296
Phone (480) 649-6600

17900 N Porter Rd
Maricopa, AZ 85138
Phone (520) 233-2500

1450 S Dobson Rd
Ste B220
Mesa, AZ 85202
Phone (480) 827-5044

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

Organizations & group practices 2

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": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449619200000",
    "number": "1457526030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 E WARNER RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852963082",
            "telephone_number": "480-649-6600",
            "fax_number": "480-649-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 E WARNER RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852963082",
            "telephone_number": "480-649-6600",
            "fax_number": "480-649-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "SUZANNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-24",
        "last_updated": "2015-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "DE",
            "license": "C7-0004038",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT193802",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "44898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUZANNE",
            "last_name": "GOLDRING",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.