Individual provider Active NPI

Susannah L. Collier, M.D.

  • MOHS-Micrographic Surgery Physician
  • Oklahoma City, OK
National Provider Identifier
1659355311
Registry record updated Dec 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
24822 Issued in OK
Practice address
3030 NW 149TH St
Oklahoma City, OK 73134-1849
Phone
(405) 562-8850
Fax
(405) 562-6550
NPI assigned
Dec 5, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2014

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 2002030861 MO
Pediatric Dermatology Physician 207NP0225X 2002030861 MO
Procedural Dermatology Physician 207NS0135X 2002030861 MO
Dermatology Physician 207N00000X 24822 OK
Pediatric Dermatology Physician 207NP0225X 24822 OK
Procedural Dermatology Physician 207NS0135X 24822 OK
MOHS-Micrographic Surgery Physician 207ND0101X 24822 OK Primary

Addresses

Primary practice location

3030 NW 149TH St
Oklahoma City, OK 73134-1849

Mailing address

3030 NW 149TH St
Oklahoma City, OK 73134-1849
Phone (405) 562-8850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20060727000048 OK Practitioner - Dermatology 4981648482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Oklahoma College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3030 NW 149TH St
Oklahoma City, OK 73134-1849
Phone (405) 562-8850

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision170
Removal of skin lesions440
Removal of skin cancer625
Skin biopsy203

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2002030861MOMDDermatology Physician
24822OKMDPediatric Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Susannah L Collier MD PLLC Mohs-Micrographic Surgery CurrentSince Aug 8, 2008 Accepting new patients

Locations

3030 NW 149th St
Oklahoma City, OK 73134
Phone (405) 562-6222

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417564800000",
    "number": "1659355311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 NW 149TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731341849",
            "telephone_number": "405-562-8850",
            "fax_number": "405-562-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 NW 149TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731341849",
            "telephone_number": "405-562-8850",
            "fax_number": "405-562-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLIER",
        "first_name": "SUSANNAH",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-05",
        "last_updated": "2014-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MO",
            "license": "2002030861",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "MO",
            "license": "2002030861",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "MO",
            "license": "2002030861",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OK",
            "license": "24822",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "OK",
            "license": "24822",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "OK",
            "license": "24822",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "OK",
            "license": "24822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.