NPIMap

Individual provider Active NPI

Dan Suskin, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Lawrenceville, GA
National Provider Identifier
1679631881
Registry record updated Aug 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
036883 Issued in GA
Practice address
700 Medical Center Blvd
Gwinnett Womens Pavilion
Lawrenceville, GA 30046-7693
Phone
(770) 921-4492
Fax
(770) 696-3358
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 036883 GA Primary

Addresses

Primary practice location

700 Medical Center Blvd
Gwinnett Womens Pavilion
Lawrenceville, GA 30046-7693

Mailing address

PO Box 2606
Lilburn, GA 30048-2606
Phone (770) 921-4492

Other identifiers 7

IdentifierTypeStateIssuer
10052477MedicaidGA
52412187OtherGABLUE CROSS
117057MedicaidGA
322063MedicaidGA
000700983DMedicaidGA
000700983FMedicaidGA
000700983BMedicaidGA

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036883GAMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ehca Johns Creek, LLC Past Accepting new patients
Piedmont Newton Hospital, Inc. Past Accepting new patients
Piedmont Rockdale Hospital Inc. Past Accepting new patients
Northside Hospital, Inc. Past Accepting new patients
Gwinnett Neonatology,PC Neonatal-Perinatal Medicine Past Accepting new patients
Neonatal Specialist of Georgia Neonatal-Perinatal Medicine Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312761600000",
    "number": "1679631881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2606",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300482606",
            "telephone_number": "770-921-4492",
            "fax_number": "770-696-3358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 MEDICAL CENTER BLVD",
            "address_2": "GWINNETT WOMENS PAVILION",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300467693",
            "telephone_number": "770-921-4492",
            "fax_number": "770-696-3358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSKIN",
        "first_name": "DAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2011-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "GA",
            "license": "036883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10052477",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "52412187",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117057",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "322063",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000700983D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000700983F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000700983B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.