Susan E Teggatz, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

33739 Issued in IA

Practice address

5409 Avenue O
Suite 1
Fort Madison, IA 52627-9601

Phone

(319) 376-2134

Fax

(319) 376-2188

NPI assigned

Jan 17, 2006

Last updated

Oct 6, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Trinity Regional Medical Center

  dba UnityPoint Clinic

  • Emergency Medicine Physician
  • Fort Dodge, IA
  • NPI 1073594156
  Medicare reassignment NPD
• Southeast Iowa Regional Medical Center, Inc.

  dba Southeast Iowa Regional Medical Center

  • General Practice Physician
  • West Burlington, IA
  • NPI 1164433884
  NPD (past)

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317859200000",
    "number": "1578542668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5409 AVENUE O",
            "address_2": "SUITE 1",
            "city": "FORT MADISON",
            "state": "IA",
            "postal_code": "526279601",
            "telephone_number": "319-376-2134",
            "fax_number": "319-376-2188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5409 AVENUE O",
            "address_2": "SUITE 1",
            "city": "FORT MADISON",
            "state": "IA",
            "postal_code": "526279601",
            "telephone_number": "319-376-2134",
            "fax_number": "319-376-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEGGATZ",
        "first_name": "SUSAN",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-17",
        "last_updated": "2011-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "33739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578542668",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BLUE CROSS BLUE SHIELD",
            "identifier": "1578542668",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph David St Clair, DC
• Timothy Staudte, D.O.
• Leah Steffensmeier, M.D.
• Regan Stellern, CPNP-PC, DNP
• Sunnybrook of Ft. Madison
• Debra J Tinguely, PHARM.D
• Lorelei LC Titus-Hooper, OTR/L
• Eugenio Torres, M.D.
• Gerald A Tripp, D.D.S
• Derek Paul Vogelpohl, O.D.

• Pediatrics Physician in Fort Madison, IA
• Providers in Fort Madison, IA by specialty
• Pediatrics Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.