Active NPI
Susan Perlmutter Pauker, MD
- Clinical Genetics (M.D.) Physician
- Somerville, MA
National Provider Identifier
1528058799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Genetics (M.D.) Physician
- License
- 34393
- Practice address
- 40 Holland St
Somerville, MA 02144-2705 - Phone
- (617) 629-6250
- Fax
- (617) 629-6108
- NPI assigned
- Oct 27, 2005
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 34393 | MA | |
| Clinical Genetics (M.D.) Physician | 207SG0201X | 34393 | MA | Primary |
Addresses
Primary practice location
40 Holland St
Somerville, MA 02144-2705
Mailing address
40 Holland St
Somerville, MA 02144-2705
Phone (617) 629-6250
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3193951 | Medicaid | MA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | spaukermd11060@direct.atrius.masshiway.net |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34393 | MA | MD | Clinical Genetics (M.D.) Physician |
Interoperability endpoints
- spaukermd11060@direct.atrius.masshiway.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614124800000",
"number": "1528058799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 HOLLAND ST",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021442705",
"telephone_number": "617-629-6250",
"fax_number": "617-629-6108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 HOLLAND ST",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021442705",
"telephone_number": "617-629-6250",
"fax_number": "617-629-6108"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAUKER",
"first_name": "SUSAN",
"middle_name": "PERLMUTTER",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-27",
"last_updated": "2021-02-24",
"certification_date": "2021-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "34393",
"primary": false
},
{
"code": "207SG0201X",
"taxonomy_group": "",
"desc": "Medical Genetics, Clinical Genetics (M.D.)",
"state": "MA",
"license": "34393",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3193951",
"state": "MA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "spaukermd11060@direct.atrius.masshiway.net",
"affiliation": "N",
"address_1": "40 Holland St",
"city": "Somerville",
"state": "MA",
"country_code": "US",
"postal_code": "021442705",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Somerville, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.