Individual provider Active NPI

Susanna R Magee, MD

  • Family Medicine Physician
  • Pawtucket, RI
National Provider Identifier
1487638003
Registry record updated May 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD10534 Issued in RI
Practice address
111 Brewster St
Family Care Center
Pawtucket, RI 02860-4400
Phone
(401) 729-2206
Fax
(401) 729-3495
NPI assigned
Dec 6, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD10534 RI Primary

Addresses

Primary practice location

111 Brewster St
Family Care Center
Pawtucket, RI 02860-4400

Mailing address

111 Brewster St
Wood BLDG 516
Pawtucket, RI 02860-4400
Phone (401) 729-3481

Other identifiers 2

IdentifierTypeStateIssuer
007061049OtherRIMEDICARE PTAN
7009042MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20090316000383 RI Practitioner - Family Practice 8921165176 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Jefferson Medical College of Thomas Jefferson University, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prime Healthcare Services Landmark LLCGroup PAC ID 3274761069, 48 clinicians

Practice addresses (Care Compare)

255 Cass Ave
Woonsocket, RI 02895-4705
Phone (401) 769-4100

Hospital & facility affiliations

  • Landmark Medical Center Hospital, Woonsocket, RI, CCN 410011
  • The Miriam Hospital Hospital, Providence, RI, CCN 410012

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Healthcare Services Landmark LLC Past Accepting new patients

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.

Hospital & facility affiliations 3

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": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274054400000",
    "number": "1487638003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 BREWSTER ST",
            "address_2": "WOOD BLDG 516",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028604400",
            "telephone_number": "401-729-3481",
            "fax_number": "401-729-2721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BREWSTER ST",
            "address_2": "FAMILY CARE CENTER",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028604400",
            "telephone_number": "401-729-2206",
            "fax_number": "401-729-3495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGEE",
        "first_name": "SUSANNA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2010-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "MD10534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "007061049",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7009042",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

Verify at the official NPI Registry.