Individual provider Active NPI

Susan Palasis, MD

  • Pediatric Radiology Physician
  • Chicago, IL
National Provider Identifier
1639142227
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
036149398 Issued in IL
Practice address
225 E Chicago Ave # 9
Chicago, IL 60611-2991
Phone
(312) 227-4500
NPI assigned
Feb 13, 2006
Last updated
Jun 27, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 036149398 IL
Pediatric Radiology Physician 2085P0229X 036149398 IL Primary
Diagnostic Radiology Physician 2085R0202X 036149398 IL

Addresses

Primary practice location

225 E Chicago Ave # 9
Chicago, IL 60611-2991

Mailing address

225 E Chicago Ave # 9
Chicago, IL 60611-2991
Phone (312) 227-4500

Other practice location 1

1001 Johnson Ferry Rd NE
Atlanta, GA 30342-1605
Phone (404) 785-2162

Other identifiers 1

IdentifierTypeStateIssuer
000809421MedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20080423000087 GA Practitioner - Diagnostic Radiology 7618054792 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc Current Accepting new patients
Emory Medical Care Foundation Inc Neuroradiology CurrentSince Mar 6, 2022 Accepting new patients
The Emory Clinic Inc Diagnostic Radiology CurrentSince Mar 6, 2022 Accepting new patients
Children's Diagnostic Imaging of Atlanta Pediatric Radiology CurrentSince Feb 1, 2005 Accepting new patients
The Emory Clinic Pediatric Providers Pediatric Radiology Past Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

1001 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 785-2008

Interoperability endpoints

  • Direct secure messaging: spalasis3636@choa.gadirect.net

Organizations & group practices 5

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1639142227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 E CHICAGO AVE # 9",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112991",
            "telephone_number": "312-227-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E CHICAGO AVE # 9",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112991",
            "telephone_number": "312-227-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Johnson Ferry Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303421605",
            "country_code": "US",
            "telephone_number": "404-785-2162",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALASIS",
        "first_name": "SUSAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "IL",
            "license": "036149398",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "IL",
            "license": "036149398",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036149398",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000809421",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.