Individual provider Active NPI

Susan Bridget Favorite, CRNA

  • Certified Registered Nurse Anesthetist
  • Ephrata, PA
National Provider Identifier
1487743464
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
071093 Issued in PA
Practice address
169 Martin Ave
Ephrata, PA 17522-1724
Phone
(717) 738-6618
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 071093 PA Primary

Addresses

Primary practice location

169 Martin Ave
Ephrata, PA 17522-1724

Mailing address

220 E 2ND Ave
Lititz, PA 17543-2024
Phone (717) 627-4431

Other identifiers 1

IdentifierTypeStateIssuer
RN302905LOtherPARN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051017000122 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 0042236325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Pittsburgh PhysiciansGroup PAC ID 8729990239, 4,166 clinicians

Practice addresses (Care Compare)

300 Halket St
Pittsburgh, PA 15213-3108

815 Freeport Rd
Pittsburgh, PA 15215-3399
Phone (412) 784-4396

Hospital & facility affiliations

  • Magee Womens Hospital of Upmc Health System Hospital, Pittsburgh, PA, CCN 390114

Merit-based Incentive Payment System (MIPS)

Final score
80.94 of 100Reported as group
Quality
61.89
Promoting interoperability
100
Improvement activities
40
Cost
74.58

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
071093PAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians Current Accepting new patients

Locations

815 Freeport Rd
Pittsburgh, PA 15215
Phone (412) 784-4000

300 Halket St
Ste 5200
Pittsburgh, PA 15213
Phone (412) 641-7850

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.

Hospital & facility affiliations 2

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487743464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 E 2ND AVE",
            "city": "LITITZ",
            "state": "PA",
            "postal_code": "175432024",
            "telephone_number": "717-627-4431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 MARTIN AVE",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175221724",
            "telephone_number": "717-738-6618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAVORITE",
        "first_name": "SUSAN",
        "middle_name": "BRIDGET",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "071093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "RN302905L",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ephrata, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.