NPIMap

Individual provider Active NPI

Susan Denise Ghani, MD

  • Internal Medicine Physician
  • Durango, CO
National Provider Identifier
1639264807
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
42057 Issued in CO
Practice address
575 Rivergate Unit 204
Durango, CO 81301-7490
Phone
(970) 403-1340
Fax
(970) 403-1341
NPI assigned
Oct 4, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 42057 CO Primary

Addresses

Primary practice location

575 Rivergate Unit 204
Durango, CO 81301-7490

Mailing address

575 Rivergate
Suite 204
Durango, CO 81301-7487
Phone (970) 403-1340

Other identifiers 1

IdentifierTypeStateIssuer
75385830MedicaidCO

Other names 1

  • Susan Denise Neadeau Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040419001705 CO Practitioner - Internal Medicine 2961497870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Emory University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Animas Surgical Hospital LLCGroup PAC ID 0143295428, 61 clinicians

Practice addresses (Care Compare)

575 Rivergate
Unit 204
Durango, CO 81301-7490
Phone (970) 403-1340

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42057COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Durango Surgery Center LLC CurrentSince Jan 15, 2011 Accepting new patients
Animas Surgical Hospital, LLC Internal Medicine CurrentSince Jan 15, 2011 Accepting new patients
California Em-I Medical Services Past Accepting new patients

Locations

450 S Camino del Rio
Durango, CO 81301
Phone (303) 842-3850

575 Rivergate Ln
Durango, CO 81301
Phone (719) 648-5678

575 Rivergate Ln
Unit 204
Durango, CO 81301
Phone (970) 382-8292

6128 S Lyncrest Ave
Sioux Falls, SD 57108
Phone (605) 334-1363

6330 S Western Ave
Ste 150
Sioux Falls, SD 57108

Organizations & group practices 3

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1639264807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 RIVERGATE",
            "address_2": "SUITE 204",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017487",
            "telephone_number": "970-403-1340",
            "fax_number": "970-403-1341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 RIVERGATE UNIT 204",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017490",
            "telephone_number": "970-403-1340",
            "fax_number": "970-403-1341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHANI",
        "first_name": "SUSAN",
        "middle_name": "DENISE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2023-03-07",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "42057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "75385830",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "NEADEAU",
            "middle_name": "DENISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Durango, CO

Sources for this page

Verify at the official NPI Registry.