Individual provider Active NPI

Susan Smith, M.D.

  • Diagnostic Radiology Physician
  • Orlando, FL
National Provider Identifier
1649278128
Registry record updated Aug 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME70923 Issued in FL
Practice address
20 W Kaley St
Orlando, FL 32806-2931
Phone
(407) 423-2581
Fax
(407) 849-6470
NPI assigned
Jul 8, 2005
Last updated
Aug 22, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X ME70923 FL
Diagnostic Radiology Physician 2085R0202X ME70923 FL Primary

Addresses

Primary practice location

20 W Kaley St
Orlando, FL 32806-2931

Mailing address

20 W Kaley St
Orlando, FL 32806-2931
Phone (407) 423-2581

Other identifiers 3

IdentifierTypeStateIssuer
300067508OtherFLRR MEDICARE
250045100MedicaidFL
31502OtherFLBCBS OF FLORIDA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20070324000020 FL Practitioner - Diagnostic Radiology 6608970025 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ohri, LLC CurrentSince Aug 19, 2015 Accepting new patients
Ohri, LLC CurrentSince Aug 19, 2015 Accepting new patients
Ohri, LLC Diagnostic Radiology Current Accepting new patients
Singleton Associates PA Pediatric Radiology CurrentSince May 15, 2024 Accepting new patients
Florida Radiology Imaging at Lake Mary LLC Diagnostic Radiology Past Accepting new patients
Florida Radiology Imaging at Lake Mary, LLC Pediatric Radiology Past Accepting new patients

Locations

398 E Altamonte Dr
Altamonte Springs, FL 32701
Phone (407) 331-3955

20 W Kaley St
Orlando, FL 32806
Phone (407) 423-2581

Networks

  • Freedom Health HMO Network

Organizations & group practices 6

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": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471824000000",
    "number": "1649278128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 W KALEY ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062931",
            "telephone_number": "407-423-2581",
            "fax_number": "407-849-6470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 W KALEY ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062931",
            "telephone_number": "407-423-2581",
            "fax_number": "407-849-6470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SUSAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-08",
        "last_updated": "2016-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "FL",
            "license": "ME70923",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME70923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "300067508",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250045100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "31502",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.