Individual provider Active NPI

Susan Cohen Zeltzer, MD

  • Family Medicine Physician
  • Southfield, MI
National Provider Identifier
1639170129
Registry record updated Feb 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301050711 Issued in MI
Practice address
22250 Providence Dr
5TH Floor
Southfield, MI 48075-4825
Phone
(248) 849-3441
Fax
(248) 849-5373
NPI assigned
Aug 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301050711 MI Primary

Addresses

Primary practice location

22250 Providence Dr
5TH Floor
Southfield, MI 48075-4825

Mailing address

15990 W 9 Mile Rd
Southfield, MI 48075-4826
Phone (248) 849-4226

Other identifiers 1

IdentifierTypeStateIssuer
260769410MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298505600000",
    "number": "1639170129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15990 W 9 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754826",
            "telephone_number": "248-849-4226",
            "fax_number": "248-849-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR",
            "address_2": "5TH FLOOR",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754825",
            "telephone_number": "248-849-3441",
            "fax_number": "248-849-5373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELTZER",
        "first_name": "SUSAN",
        "middle_name": "COHEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2011-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301050711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260769410",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.