Individual provider Active NPI

Susan J Maurer, PA

  • Medical Physician Assistant
  • Port St Lucie, FL
National Provider Identifier
1700873890
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA 9101946 Issued in FL
Practice address
2266 SW Best St
Port St Lucie, FL 34984-4307
Phone
(772) 245-1216
Fax
(833) 455-8830
NPI assigned
Oct 4, 2005
Last updated
Sep 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA 9101946 FL Primary

Addresses

Primary practice location

2266 SW Best St
Port St Lucie, FL 34984-4307

Mailing address

2266 SW Best St
Port St Lucie, FL 34984-4307
Phone (772) 245-1216

Other identifiers 1

IdentifierTypeStateIssuer
291399200MedicaidFL

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 9101946FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gulfstream Emergency Physicians Past Accepting new patients

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, 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": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789948800000",
    "number": "1700873890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2266 SW BEST ST",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349844307",
            "telephone_number": "772-245-1216",
            "fax_number": "833-455-8830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2266 SW BEST ST",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349844307",
            "telephone_number": "772-245-1216",
            "fax_number": "833-455-8830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURER",
        "first_name": "SUSAN",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-04",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA 9101946",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291399200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; 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.