Individual provider Active NPI

Susan D Urstein, MD

  • Emergency Medicine Physician
  • Santa Monica, CA
National Provider Identifier
1528025558
Registry record updated Jan 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A69962 Issued in CA
Practice address
1328 Twenty Second Street
Santa Monica, CA 90404-2091
Phone
(310) 582-7089
NPI assigned
Apr 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A69962 CA Primary

Addresses

Primary practice location

1328 Twenty Second Street
Santa Monica, CA 90404-2091

Mailing address

PO Box 12079
Westminster, CA 92685-3852
Phone (562) 809-3595

Other identifiers 1

IdentifierTypeStateIssuer
00A699620MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20041215000292 CA Practitioner - Emergency Medicine 9234196890 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.64 of 100Reported as group
Quality
80.76
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A69962CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacifica Emergency Medical Associates Emergency Medicine CurrentSince Aug 29, 2018 Accepting new patients
Tarzana Emergency Medical Associates Emergency Medicine CurrentSince Jan 16, 2018 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America - California Emergency Medicine CurrentSince Jun 29, 2021 Accepting new patients
Cep America-California Emergency Medicine CurrentSince Jun 29, 2021 Accepting new patients
Telemedicine365 Inc Emergency Medicine CurrentSince Jan 1, 2021 Accepting new patients
Saint Johns Emergency Medicine Specialists Inc a Medical Group Emergency Medicine CurrentSince Aug 1, 2003 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

18321 Clark St
Tarzana, CA 91356
Phone (310) 423-6744

16237 Ventura Blvd
Van Nuys, CA 91436
Phone (818) 995-5000

Organizations & group practices 7

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231718400000",
    "number": "1528025558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12079",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926853852",
            "telephone_number": "562-809-3595",
            "fax_number": "562-468-0347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1328 TWENTY SECOND STREET",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042091",
            "telephone_number": "310-582-7089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URSTEIN",
        "first_name": "SUSAN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2009-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A69962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A699620",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.