Individual provider Active NPI

Susan Hall, M.D.

  • Family Medicine Physician
  • Tehachapi, CA
National Provider Identifier
1578649067
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A76766 Issued in CA
Practice address
432A West J Street
Tehachapi, CA 93561
Phone
(661) 822-4421
Fax
(661) 822-6250
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A76766 CA Primary

Addresses

Primary practice location

432A West J Street
Tehachapi, CA 93561

Mailing address

PO Box 2357
Tehachapi, CA 93581-2357
Phone (661) 822-4421

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
I20041110000441 CA Practitioner - Family Practice 1254394570 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Southern California Keck School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centric HealthGroup PAC ID 8729009030, 66 clinicians

Practice addresses (Care Compare)

2901 Sillect Ave
Suite 100
Bakersfield, CA 93308-6372
Phone (661) 323-8384

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A76766CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centric Health CurrentSince Jan 1, 2020 Accepting new patients
Centric Health Current Accepting new patients

Locations

3001 Sillect Ave
Bakersfield, CA 93308
Phone (661) 316-6000

2901 Sillect Ave
Ste 100
Bakersfield, CA 93308
Phone (805) 323-8384

432 W J St
Ste A
Tehachapi, CA 93561
Phone (661) 332-4278

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 and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1578649067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2357",
            "city": "TEHACHAPI",
            "state": "CA",
            "postal_code": "935812357",
            "telephone_number": "661-822-4421",
            "fax_number": "661-822-6250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432A WEST J STREET",
            "city": "TEHACHAPI",
            "state": "CA",
            "postal_code": "93561",
            "telephone_number": "661-822-4421",
            "fax_number": "661-822-6250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A76766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tehachapi, CA

Sources for this page

Verify at the official NPI Registry.