Active NPI
Savitha Susarla, D.O.
- Family Medicine Physician
- Elgin, IL
National Provider Identifier
1518976323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036-113639
- Practice address
- 860 Summit St
Ste 123
Elgin, IL 60120-5145 - Phone
- (847) 741-0026
- Fax
- (847) 741-0027
- NPI assigned
- Aug 8, 2006
- Last updated
- Jan 4, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036-113639 | IL | Primary |
Addresses
Primary practice location
860 Summit St
Ste 123
Elgin, IL 60120-5145
Mailing address
860 Summit St
Ste 123
Elgin, IL 60120-5145
Phone (847) 741-0026
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0004500476 | Other | IL | BLUE CROSS BLUE SHIELD |
| P00292442 | Other | IL | RAILROAD MEDICARE |
| 036113639 | Medicaid | IL |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | savitha.susarla@vsm.eclinicaldirect.com | ||
| FHIR URL | https://fhir.healow.com/FHIRServer/fhir/FCGBAA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Kansas City College of Medicine and Surgery, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
860 Summit St
Suite 123
Elgin, IL 60120-4350
Phone (847) 741-0026
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-113639 | IL | MD | Family Medicine Physician |
Interoperability endpoints
- ssusarla287566@direct.myadvocateaurora.org
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Internal Medicine Physician
- Elgin, IL
- NPI 1952583783
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Elgin, IL
- NPI 1629026364
-
dba Advocate Home Health Services
- Home Health Agency
- Oak Brook, IL
- NPI 1598732075
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641254400000",
"number": "1518976323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "860 SUMMIT ST",
"address_2": "STE 123",
"city": "ELGIN",
"state": "IL",
"postal_code": "601205145",
"telephone_number": "847-741-0026",
"fax_number": "847-741-0027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "860 SUMMIT ST",
"address_2": "STE 123",
"city": "ELGIN",
"state": "IL",
"postal_code": "601205145",
"telephone_number": "847-741-0026",
"fax_number": "847-741-0027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUSARLA",
"first_name": "SAVITHA",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-08",
"last_updated": "2022-01-04",
"certification_date": "2022-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036-113639",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0004500476",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00292442",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036113639",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "savitha.susarla@vsm.eclinicaldirect.com",
"affiliation": "N",
"address_1": "860 Summit St",
"address_2": "Ste 123",
"city": "Elgin",
"state": "IL",
"country_code": "US",
"postal_code": "601205145",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://fhir.healow.com/FHIRServer/fhir/FCGBAA",
"affiliation": "N",
"address_1": "860 Summit St",
"address_2": "Ste 123",
"city": "Elgin",
"state": "IL",
"country_code": "US",
"postal_code": "601205145",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Elgin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.