Organization Active NPI

Susan T. Savulak, MD, LLC

  • Psychiatry Physician
  • Southington, CT
National Provider Identifier
1588062541
Registry record updated Dec 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
035159 Issued in CT
Legal business name
SUSAN T. SAVULAK, MD, LLC
Practice address
31 Liberty St
Unit 111
Southington, CT 06489-3114
Phone
(860) 276-0191
Fax
(860) 276-0195
NPI assigned
Dec 8, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2014

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

Authorized official

Name
Dr. Susan T Savulak, M.D.NPI 1962495606
Title
Member
Phone
(860) 276-0191

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
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 035159 CT Primary

Addresses

Primary practice location

31 Liberty St
Unit 111
Southington, CT 06489-3114

Mailing address

31 Liberty St
Unit 111
Southington, CT 06489-3114
Phone (860) 276-0191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150313000084 CT Part B Supplier - Clinic/Group Practice 5395061113 Receives reassigned benefits from 1 practitioner
Practice locations: Southington, CT

National Provider Directory

National Provider Directory

Locations

31 Liberty St
Ste 211
Southington, CT 06489
Phone (860) 276-0191

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1417996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417996800000",
    "number": "1588062541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 LIBERTY ST",
            "address_2": "UNIT 111",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064893114",
            "telephone_number": "860-276-0191",
            "fax_number": "860-276-0195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 LIBERTY ST",
            "address_2": "UNIT 111",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064893114",
            "telephone_number": "860-276-0191",
            "fax_number": "860-276-0195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN T. SAVULAK, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-08",
        "last_updated": "2014-12-08",
        "status": "A",
        "authorized_official_last_name": "SAVULAK",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "860-276-0191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "035159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2014; 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.