Individual provider Active NPI

Susan Kaweski, M.D., F.A.C.S.

  • Plastic and Reconstructive Surgery Physician
  • La Mesa, CA
National Provider Identifier
1629076856
Registry record updated Apr 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
G53909 Issued in CA
Practice address
8415 Grant Ave
La Mesa, CA 91941-5303
Phone
(619) 464-9876
Fax
(616) 464-9877
NPI assigned
Jul 12, 2005
Last updated
Apr 4, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ph.D. Medical Genetics 170100000X G53909 PA
Plastic and Reconstructive Surgery Physician 2086S0122X G53909 CA Primary

Addresses

Primary practice location

8415 Grant Ave
La Mesa, CA 91941-5303

Mailing address

8415 Grant Ave
La Mesa, CA 91941
Phone (619) 464-9876

Other identifiers 2

IdentifierTypeStateIssuer
1145416243MedicaidCA
1629076856MedicaidCA

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
I20040518001131 CA Practitioner - Plastic and Reconstructive SurgeryPractitioner - General Surgery 6305836842 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: General Surgery
Education
Pennsylvania State University College of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8415 Grant Ave
La Mesa, CA 91941-5303
Phone (619) 464-9876

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G53909PAMDPh.D. Medical Genetics
G53909CAMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aesthetic Arts Institute of Plastic Surgery LLC CurrentSince Dec 8, 2008 Accepting new patients
Emergency and Acute Care Medical Corporation CurrentSince Feb 26, 2017 Accepting new patients
Susan Kaweski, M.D. a Professional CurrentSince Mar 1, 2004 Accepting new patients
Scripps Health Past Accepting new patients
Rady Children's Hospital San Diego Past Accepting new patients
Sharp Memorial Hospital Past Accepting new patients

Locations

8415 Grant Ave
Ste 401
La Mesa, CA 91941

8415 Grant Ave
La Mesa, CA 91941
Phone (619) 460-2672

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

23625 Wr Holman Hwy
Monterey, CA 93940
Phone (831) 622-2708

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522800000000",
    "number": "1629076856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8415 GRANT AVE",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "91941",
            "telephone_number": "619-464-9876",
            "fax_number": "619-464-9877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8415 GRANT AVE",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919415303",
            "telephone_number": "619-464-9876",
            "fax_number": "616-464-9877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAWESKI",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "M.D., F.A.C.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2018-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170100000X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Ph.D. Medical Genetics",
            "state": "PA",
            "license": "G53909",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "G53909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1145416243",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629076856",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.