Individual provider Active NPI

Susan D Peck, D.O.

  • Addiction Medicine (Preventive Medicine) Physician
  • Hanover, PA
National Provider Identifier
1588643233
Registry record updated Mar 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X
License
OS004392L Issued in PA
Practice address
300 Frederick St
Hanover, PA 17331-3709
Phone
(717) 316-2255
NPI assigned
Jan 11, 2006
Last updated
Mar 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X OS004392L PA
Addiction Medicine (Preventive Medicine) Physician 2083A0300X OS004392L PA Primary

Addresses

Primary practice location

300 Frederick St
Hanover, PA 17331-3709

Mailing address

300 Frederick St
Hanover, PA 17331-3709
Phone (717) 316-2255

Other identifiers 4

IdentifierTypeStateIssuer
01808201OtherPACAPITAL BC / KEYSTONE
1519553OtherPAGATEWAY
PE427802OtherPAPA BLUE SHIELD
097088207MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address speck86398@phsdirect.pinnaclehealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20110620000682 PA Practitioner - Obstetrics/Gynecology 7911185046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Philadelphia College of Osteopathic Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Health Medical ServicesGroup PAC ID 7618960493, 1,025 clinicians

Practice addresses (Care Compare)

2501 N 3Rd St
Kline Health Center Foot and Ankle
Harrisburg, PA 17110-1904
Phone (717) 782-2100

2501 N 3Rd St 2ND FL Kline HC
Reach Program
Harrisburg, PA 17110-1904
Phone (717) 782-2363

2501 N 3Rd St FL
2 Kline Health Center
Harrisburg, PA 17110-1904
Phone (717) 782-2100

2501 N 3Rd Street 2ND Floor
Pinnaclehealth Psychological Associates
Harrisburg, PA 17110-1904
Phone (717) 782-2143

300 Frederick St
Hanover, PA 17331-3709
Phone (717) 316-2255

Merit-based Incentive Payment System (MIPS)

Final score
86.08 of 100Reported as group
Quality
76.48
Promoting interoperability
100
Improvement activities
40
Cost
77.12

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services CurrentSince Nov 1, 2018 Accepting new patients
Pinnacle Health Medical Services CurrentSince Nov 1, 2018 Accepting new patients
Pinnacle Health Medical Services Obstetrics & Gynecology Current Accepting new patients
Pinnacle Health Medical Services Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1404 Baltimore St
Ste 4
Hanover, PA 17331
Phone (717) 637-0470

18 North St
Hanover, PA 17331
Phone (717) 637-7755

20 North St
Hanover, PA 17331
Phone (717) 637-7755

300 Frederick St
Hanover, PA 17331
Phone (717) 316-2255

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

409 S 2nd St
Harrisburg, PA 17104
Phone (717) 230-3459

2030 Thistle Hill Dr
Ste 100
Spring Grove, PA 17362
Phone (717) 225-6170

Organizations & group practices 5

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": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1588643233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 FREDERICK ST",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173313709",
            "telephone_number": "717-316-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 FREDERICK ST",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173313709",
            "telephone_number": "717-316-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "SUSAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-11",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "OS004392L",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "PA",
            "license": "OS004392L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BC / KEYSTONE",
            "identifier": "01808201",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "1519553",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA BLUE SHIELD",
            "identifier": "PE427802",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "097088207",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "speck86398@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "20 North St",
            "city": "Hanover",
            "state": "PA",
            "country_code": "US",
            "postal_code": "173312275",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hanover, PA

Sources for this page

Verify at the official NPI Registry.