NPIMap

Organization Active NPI

Suzanne L. Phillips, D.P.M., P.C.

  • Foot & Ankle Surgery Podiatrist
  • Richboro, PA
National Provider Identifier
1528375334
Registry record updated Jun 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
SC005525 Issued in PA
Legal business name
SUZANNE L. PHILLIPS, D.P.M., P.C.
Practice address
1073 Second Street Pike
Richboro, PA 18954-1803
Phone
(267) 288-5103
Fax
(267) 288-5108
NPI assigned
Sep 1, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2011

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

Authorized official

Name
Dr. Suzanne Phillips, D.P.M.NPI 1053349589
Title
Podiatrist/Owner
Phone
(267) 288-5103

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X SC005525 PA Primary

Addresses

Primary practice location

1073 Second Street Pike
Richboro, PA 18954-1803

Mailing address

1073 Second Street Pike
Richboro, PA 18954-1803
Phone (267) 288-5103

Other identifiers 4

IdentifierTypeStateIssuer
6460450001OtherPAPTAN
1389267OtherPAHIGHMARK BLUE SHIELD
30080124OtherPAKEYSTONE MERCY GROUP PROVIDER NUMBER
057434YCP8OtherPAMEDICARE GROUP PROVIDER NUMBER

Other names 1

  • Bucks County Podiatry Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20101202000298 PA DME Supplier - Physician - Podiatry 2163618117 Practice locations: Richboro, PA
O20101210000123 PA Part B Supplier - Clinic/Group Practice 2163618117 Receives reassigned benefits from 1 practitioner
Practice locations: Richboro, PA

National Provider Directory

National Provider Directory

Locations

1073 2nd Street Pike
Richboro, PA 18954
Phone (267) 288-5103

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1283299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308009600000",
    "number": "1528375334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1073 SECOND STREET PIKE",
            "city": "RICHBORO",
            "state": "PA",
            "postal_code": "189541803",
            "telephone_number": "267-288-5103",
            "fax_number": "267-288-5108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1073 SECOND STREET PIKE",
            "city": "RICHBORO",
            "state": "PA",
            "postal_code": "189541803",
            "telephone_number": "267-288-5103",
            "fax_number": "267-288-5108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUZANNE L. PHILLIPS, D.P.M., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-01",
        "last_updated": "2011-06-14",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "PODIATRIST/OWNER",
        "authorized_official_telephone_number": "267-288-5103",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC005525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "6460450001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1389267",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY GROUP PROVIDER NUMBER",
            "identifier": "30080124",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PROVIDER NUMBER",
            "identifier": "057434YCP8",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bucks County Podiatry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Richboro, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.