Individual provider Active NPI

Susan Denise Baer, FNP

  • Family Nurse Practitioner
  • Cupertino, CA
National Provider Identifier
1679684906
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
13439 Issued in CA
Practice address
19000 Homestead Rd
CDRP, 1St Floor
Cupertino, CA 95014-0712
Phone
(408) 366-4200
NPI assigned
Aug 31, 2006
Last updated
Dec 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 13439 CA Primary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 492005 CA

Addresses

Primary practice location

19000 Homestead Rd
CDRP, 1St Floor
Cupertino, CA 95014-0712

Mailing address

19000 Homestead Rd
CDRP, 1St Floor
Cupertino, CA 95014-0712
Phone (408) 366-4200

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040122001228 CA Practitioner - Nurse Practitioner 3274435961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

710 Lawrence Express Way
Santa Clara, CA 95051-5173
Phone (408) 851-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
492005CAMDAddiction (Substance Use Disorder) Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc CurrentSince Feb 19, 2011 Accepting new patients
Permanente Medical Group, Inc CurrentSince Feb 19, 2011 Accepting new patients

Locations

19000 Homestead Rd
Cupertino, CA 95014
Phone (408) 366-4200

19000 Homestead Rd
Fl 1
Cupertino, CA 95014
Phone (408) 366-4200

1800 Harrison St
Fl 7
Oakland, CA 94612

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

Organizations & group practices 2

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1679684906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19000 HOMESTEAD RD",
            "address_2": "CDRP, 1ST FLOOR",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950140712",
            "telephone_number": "408-366-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19000 HOMESTEAD RD",
            "address_2": "CDRP, 1ST FLOOR",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950140712",
            "telephone_number": "408-366-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAER",
        "first_name": "SUSAN",
        "middle_name": "DENISE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "13439",
            "primary": true
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "492005",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "19000 Homestead Rd",
            "city": "Cupertino",
            "state": "CA",
            "country_code": "US",
            "postal_code": "950140712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cupertino, CA

Sources for this page

Verify at the official NPI Registry.