Individual provider Active NPI

Susan Renee Clanzy, M.D.

  • General Practice Physician
  • Baltimore, MD
National Provider Identifier
1568435634
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
D0060902 Issued in MD
Practice address
1804 W North Ave
Baltimore, MD 21217-1621
Phone
(410) 685-6331
Fax
(410) 685-6332
NPI assigned
Feb 9, 2006
Last updated
Dec 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X D0060902 MD Primary

Addresses

Primary practice location

1804 W North Ave
Baltimore, MD 21217-1621

Mailing address

1804 W North Ave
Baltimore, MD 21217-1621
Phone (410) 685-6331

Other identifiers 1

IdentifierTypeStateIssuer
3364208 00MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20071108000104 MD Practitioner - General PracticePractitioner - Addiction Medicine 4587751573 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Total Health Care Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GJFJBD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1568435634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 W NORTH AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212171621",
            "telephone_number": "410-685-6331",
            "fax_number": "410-685-6332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 W NORTH AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212171621",
            "telephone_number": "410-685-6331",
            "fax_number": "410-685-6332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLANZY",
        "first_name": "SUSAN",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MD",
            "license": "D0060902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3364208 00",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.