Individual provider Active NPI

Suzanne C Christie, M.D.

  • Pediatrics Physician
  • Mill Valley, CA
National Provider Identifier
1629002985
Registry record updated Jan 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G80284 Issued in CA
Practice address
655 Redwood Hwy Frontage Rd
# 216
Mill Valley, CA 94941-3034
Phone
(415) 383-3500
Fax
(415) 383-3554
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G80284 CA Primary

Addresses

Primary practice location

655 Redwood Hwy Frontage Rd
# 216
Mill Valley, CA 94941-3034

Mailing address

1206 Strawberry VLG
Mill Valley, CA 94941-2372
Phone (415) 388-3364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20190212000367 CA Practitioner - Pediatric Medicine 7315285673 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G80284CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents Univ of California UCSF Pediatrics CurrentSince Nov 26, 2018 Accepting new patients
Mill Valley Pediatric Associates Pediatrics Past Accepting new patients

Locations

655 Redwood Hwy Frontage Rd
Ste 216
Mill Valley, CA 94941
Phone (415) 380-8711

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

3333 California St
#S110
San Francisco, CA 94118
Phone (415) 514-2664

Interoperability endpoints

  • Direct secure messaging: schristie105870@direct-ucsfmedicalcenter.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295395200000",
    "number": "1629002985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 STRAWBERRY VLG",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412372",
            "telephone_number": "415-388-3364",
            "fax_number": "415-388-3385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 REDWOOD HWY FRONTAGE RD",
            "address_2": "# 216",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949413034",
            "telephone_number": "415-383-3500",
            "fax_number": "415-383-3554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTIE",
        "first_name": "SUZANNE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2011-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G80284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Valley, CA

Sources for this page

Verify at the official NPI Registry.