Active NPI
Susan Elaine Ardisson, P.A.
- Physician Assistant
- Salinas, CA
National Provider Identifier
1497769079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA11426
- Practice address
- 559 E Alisal St
Suite 201
Salinas, CA 93905-2516 - Phone
- (831) 769-8800
- Fax
- (831) 422-9312
- NPI assigned
- Jul 28, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA11426 | CA | Primary |
Addresses
Primary practice location
559 E Alisal St
Suite 201
Salinas, CA 93905-2516
Mailing address
1615 Bunker Hill Way
Suite 100
Salinas, CA 93906-6013
Phone (831) 769-1304
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| FHC70832F | Medicaid | CA | |
| N9263201 | Other | CA | DRIVER LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA11426 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302220800000",
"number": "1497769079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1615 BUNKER HILL WAY",
"address_2": "SUITE 100",
"city": "SALINAS",
"state": "CA",
"postal_code": "939066013",
"telephone_number": "831-769-1304",
"fax_number": "831-757-0291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "559 E ALISAL ST",
"address_2": "SUITE 201",
"city": "SALINAS",
"state": "CA",
"postal_code": "939052516",
"telephone_number": "831-769-8800",
"fax_number": "831-422-9312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARDISSON",
"first_name": "SUSAN",
"middle_name": "ELAINE",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-28",
"last_updated": "2011-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA11426",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "FHC70832F",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVER LICENSE",
"identifier": "N9263201",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Salinas, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.