NPIMap

Individual provider Active NPI

Susan M Flick, CNP

  • Adult Health Nurse Practitioner
  • Mayfield Heights, OH
National Provider Identifier
1710175179
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
09704NP Issued in OH
Practice address
300 Allen Bradley Dr Ste 240
Mayfield Heights, OH 44124-6130
Phone
(216) 382-8000
Fax
(216) 297-3233
NPI assigned
Oct 11, 2007
Last updated
Jun 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 09704NP OH Primary
Adult Health Nurse Practitioner 363LA2200X COA.09704-NP OH

Addresses

Primary practice location

300 Allen Bradley Dr Ste 240
Mayfield Heights, OH 44124-6130

Mailing address

300 Allen Bradley Dr Ste 240
Mayfield Heights, OH 44124-6130
Phone (216) 382-8000

Other identifiers 2

IdentifierTypeStateIssuer
464794OtherOHWELLCARE
2839343MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address susanflick@uhps.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081025000036 OH Practitioner - Nurse Practitioner 5799843330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Customcare MD LLCGroup PAC ID 5092744540, 3 clinicians

Practice addresses (Care Compare)

300 Allen Bradley Dr
Suite 240
Mayfield Heights, OH 44124-6130
Phone (216) 381-1520

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
09704NPOHMDAdult Health Nurse Practitioner
COA.09704-NPOHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Customcare MD LLC CurrentSince Oct 1, 2023 Accepting new patients
Multicare Health System Past Accepting new patients

Locations

300 Allen Bradley Dr
Ste 240
Mayfield Heights, OH 44124
Phone (216) 381-1520

1611 S Green Rd
Ste 213
South Euclid, OH 44121
Phone (216) 381-1520

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21616/brand/1/csg/1/fhir/r4
  • Direct secure messaging: sflick558047@ehrdirect.uhhospitals.org

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1710175179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 ALLEN BRADLEY DR STE 240",
            "city": "MAYFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441246130",
            "telephone_number": "216-382-8000",
            "fax_number": "216-297-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 ALLEN BRADLEY DR STE 240",
            "city": "MAYFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441246130",
            "telephone_number": "216-382-8000",
            "fax_number": "216-297-3233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLICK",
        "first_name": "SUSAN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-11",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "09704NP",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "COA.09704-NP",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "464794",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2839343",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "susanflick@uhps.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "11100 Euclid Ave",
            "address_2": "Lakeside 4th Floor Urology Suite",
            "city": "Cleveland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441061716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mayfield Heights, OH

Sources for this page

Verify at the official NPI Registry.