Individual provider Active NPI

Suzy Fawzy Nashed, MD

  • Psychiatry Physician
  • Elkton, MD
National Provider Identifier
1629062492
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
D0060959 Issued in MD
Practice address
111 W High St
Suite 315
Elkton, MD 21921-5529
Phone
(410) 392-8770
Fax
(410) 392-2645
NPI assigned
Sep 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X C10007499 DE
Psychiatry Physician 2084P0800X D0060959 MD Primary

Addresses

Primary practice location

111 W High St
Suite 315
Elkton, MD 21921-5529

Mailing address

111 W High St
Suite 315
Elkton, MD 21921-5529
Phone (410) 392-8770

Other names 1

  • Suzy F Hanna Mikhail Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090416000131 MD Practitioner - Psychiatry 8426050766
I20231107002102 DC Practitioner - PsychiatryPractitioner - Neurology 8426050766 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C10007499DEMDPsychiatry Physician
D0060959MDMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Psychiatry Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Nov 6, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Nov 6, 2023 Accepting new patients
State of de Past Accepting new patients

Locations

2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

Organizations & group practices 4

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": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1629062492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W HIGH ST",
            "address_2": "SUITE 315",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219215529",
            "telephone_number": "410-392-8770",
            "fax_number": "410-392-2645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W HIGH ST",
            "address_2": "SUITE 315",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219215529",
            "telephone_number": "410-392-8770",
            "fax_number": "410-392-2645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASHED",
        "first_name": "SUZY",
        "middle_name": "FAWZY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-07",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "DE",
            "license": "C10007499",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D0060959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "111 W High St",
            "address_2": "Suite 315",
            "city": "Elkton",
            "state": "MD",
            "country_code": "US",
            "postal_code": "219215529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SUZY",
            "last_name": "HANNA MIKHAIL",
            "middle_name": "F",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Elkton, MD

Sources for this page

Verify at the official NPI Registry.