NPIMap

Organization Active NPI

Suson Optical Corporation

  • Eyewear Supplier
  • Wauwatosa, WI
National Provider Identifier
1598889727
Registry record updated Dec 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
SUSON OPTICAL CORPORATION
Practice address
2300 N Mayfair Rd
Suite 1101
Wauwatosa, WI 53226-1505
Phone
(414) 443-5289
Fax
(414) 475-5550
NPI assigned
Mar 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2012

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

Authorized official

Name
Dr. John D Suson, M.D.NPI 1619047735
Title
President
Phone
(414) 475-5550

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
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

2300 N Mayfair Rd
Suite 1101
Wauwatosa, WI 53226-1505

Mailing address

2300 N Mayfair Rd
Suite 1101
Wauwatosa, WI 53226-1505
Phone (414) 443-5289

Other identifiers 4

IdentifierTypeStateIssuer
32237800MedicaidWI
38530200MedicaidWI
30936300MedicaidWI
32169600MedicaidWI

National Provider Directory

National Provider Directory

Locations

2300 N Mayfair Rd
Ste 1101
Wauwatosa, WI 53226
Phone (414) 475-5550

Practitioners & affiliated clinicians

Practitioners 3

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": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356048000000",
    "number": "1598889727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 N MAYFAIR RD",
            "address_2": "SUITE 1101",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532261505",
            "telephone_number": "414-443-5289",
            "fax_number": "414-475-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 N MAYFAIR RD",
            "address_2": "SUITE 1101",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532261505",
            "telephone_number": "414-443-5289",
            "fax_number": "414-475-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSON OPTICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2012-12-21",
        "status": "A",
        "authorized_official_last_name": "SUSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-475-5550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32237800",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38530200",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30936300",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32169600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.