Susannah E. Nicholson, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

P6688 Issued in TX

Practice address

4502 Medical Dr
San Antonio, TX 78229-4402

Phone

(210) 358-2015

NPI assigned

Jan 8, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

General Surgery

Education

University of Texas Medical School at San Antonio, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Texas Health Science Center at San AntonioGroup PAC ID 0042128548, 1,290 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Health System Hospital, San Antonio, TX, CCN 450213
• Peterson Regional Medical Center Hospital, Kerrville, TX, CCN 450007

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• University of Texas Health Science Center at San Antonio

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1720051717

  Surgery

  Medicare reassignment Care Compare group NPD
• The University of Texas Health Science Center at San Antonio

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1326829904
  NPD
• University of Texas Health Science Center at San Antonio

  • Diagnostic Radiology Physician
  • Boerne, TX
  • NPI 1417921834
  NPD
• Bexar County Hospital District

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1821011248
  NPD (past)

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

• Bexar County Hospital District

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1821011248
  Care Compare affiliation
• Sid Peterson Memorial Hospital

  • Rural Acute Care Hospital
  • Kerrville, TX
  • NPI 1790782704
  Care Compare affiliation

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385424000000",
    "number": "1679758718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7703 FLOYD CURL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-358-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "SUSANNAH",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-08",
        "last_updated": "2013-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "P6688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "322089901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID CSHCN",
            "identifier": "322089902",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Troy Nichols
• Alysia Nicholson, DDS
• Christopher Diego Nicholson
• Ella Nicholson, SLP ASSISTANT
• Mekayla Nicholson, OTD, OTR/L
• William Dale Nicholson, LCDC
• Nick S Aguilar MD PA
• Shelly R Nickels, MD
• Abigail Nickelson, IONM
• Corey Phillips Nickerson

• Surgery Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.