Individual provider Active NPI

Susan C Gilman, M.D.

  • Psychiatry Physician
  • Wynnewood, PA
National Provider Identifier
1619986148
Registry record updated Nov 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD024318E Issued in PA
Practice address
1305 Medford Rd
Wynnewood, PA 19096-2418
Phone
(215) 482-4827
Fax
(215) 482-4828
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Psychiatry Physician 2084P0805X MD024318E PA
Psychiatry Physician 2084P0800X MD024318E PA Primary

Addresses

Primary practice location

1305 Medford Rd
Wynnewood, PA 19096-2418

Mailing address

27 Wiltshire Rd
Wynnewood, PA 19096-3644
Phone (215) 482-4827

Other identifiers 1

IdentifierTypeStateIssuer
000774110MedicaidPA

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
I20120119000715 PA Practitioner - PsychiatryPractitioner - Geriatric Psychiatry 8820061963

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD024318EPAMDGeriatric Psychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731196800000",
    "number": "1619986148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 WILTSHIRE RD",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963644",
            "telephone_number": "215-482-4827",
            "fax_number": "215-482-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 MEDFORD RD",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190962418",
            "telephone_number": "215-482-4827",
            "fax_number": "215-482-4828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMAN",
        "first_name": "SUSAN",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2024-11-10",
        "certification_date": "2024-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "PA",
            "license": "MD024318E",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD024318E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000774110",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

Verify at the official NPI Registry.