Individual provider Active NPI

Susan Johntz, M.D.

  • Psychiatry Physician
  • Haverford, PA
National Provider Identifier
1619128907
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD045066L Issued in PA
Practice address
100 Grays LN Apt 201
Haverford, PA 19041-1753
Phone
(610) 291-6706
NPI assigned
Oct 5, 2008
Last updated
Jul 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X MD045066L PA Primary

Addresses

Primary practice location

100 Grays LN Apt 201
Haverford, PA 19041-1753

Mailing address

100 Grays LN Apt 201
Haverford, PA 19041-1753
Phone (610) 291-6706

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
I20031112000134 PA Practitioner - Psychiatry 1658284922 Practice locations: Bryn Mawr, PA

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Medical College of Pennsylvania, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1341 Montgomery Ave
Bryn Mawr, PA 19010-1628
Phone (610) 291-6706

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD045066LPAMDPsychoanalyst

NPI Registry JSON

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

{
    "created_epoch": "1223164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1619128907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GRAYS LN APT 201",
            "city": "HAVERFORD",
            "state": "PA",
            "postal_code": "190411753",
            "telephone_number": "610-291-6706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GRAYS LN APT 201",
            "city": "HAVERFORD",
            "state": "PA",
            "postal_code": "190411753",
            "telephone_number": "610-291-6706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNTZ",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-05",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD045066L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haverford, PA

Sources for this page

Verify at the official NPI Registry.