Individual provider Active NPI

Suzanne D Conzen, MD

  • Medical Oncology Physician
  • Dallas, TX
National Provider Identifier
1518029073
Registry record updated Apr 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
S5870 Issued in TX
Practice address
2201 Inwood Road 3Rd Floor -NC3.500
Dallas, TX 75390-6686
Phone
(214) 645-4673
NPI assigned
Dec 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 036094337 IL
Medical Oncology Physician 207RX0202X S5870 TX Primary

Addresses

Primary practice location

2201 Inwood Road 3Rd Floor -NC3.500
Dallas, TX 75390-6686

Mailing address

PO Box 845347
Dallas, TX 75284-7208
Phone (214) 645-4673

Other practice location 1

180 Harvester Dr Ste 110
Burr Ridge, IL 60527-6686
Phone (773) 834-4064

Other identifiers 1

IdentifierTypeStateIssuer
036094337MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20200420002247 TX Practitioner - Hematology/OncologyPractitioner - Internal Medicine 8123038189 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Yale University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2201 Inwood Rd
Dallas, TX 75235-7320
Phone (214) 645-0624

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Apr 3, 2020 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Apr 3, 2020 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients

Locations

6201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 633-4700

2201 Inwood Rd
Fl 3
Dallas, TX 75235
Phone (214) 648-4180

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 3

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 1

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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586131200000",
    "number": "1518029073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847208",
            "telephone_number": "214-645-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 INWOOD ROAD 3RD FLOOR -NC3.500",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753906686",
            "telephone_number": "214-645-4673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "180 Harvester Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Burr Ridge",
            "state": "IL",
            "postal_code": "605276686",
            "country_code": "US",
            "telephone_number": "773-834-4064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONZEN",
        "first_name": "SUZANNE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IL",
            "license": "036094337",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "TX",
            "license": "S5870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036094337",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.