Susan Marie Ditter, M.D., M.P.H.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

G87843 Issued in CA

Practice address

2221 Enborg LN
San Jose, CA 95128-2608

Phone

(408) 885-6220

Fax

(408) 885-3977

NPI assigned

May 30, 2007

Last updated

Apr 3, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Emory University School of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Comprehensive Psychiatric Services a Medical GroupGroup PAC ID 0244329969, 74 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Comprehensive Psychiatric Services, a Medical Group

  • Psychiatry Physician
  • Walnut Creek, CA
  • NPI 1184785834
  Medicare reassignment Care Compare group NPD
• County of Santa Clara

  dba Las Plumas Mental Health Services MH Cyf

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Jose, CA
  • NPI 1437269917
  Medicare reassignment NPD
• University of Virginia Physicians Group

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Charlottesville, VA
  • NPI 1033138250
  NPD (past)

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207180800000",
    "number": "1710188438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 ENBORG LN",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282608",
            "telephone_number": "408-885-6220",
            "fax_number": "408-885-3977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 ENBORG LN",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282608",
            "telephone_number": "408-885-6220",
            "fax_number": "408-885-3977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITTER",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2008-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G87843",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101236675",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "024803",
            "primary": false
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "VA",
            "license": "0101236675",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "024803",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Asuncion Purisima Disini, M.D.
• Disruptive Therapy Collective
• Disruptive Therapy Collective for the Individual, Family, and Child (Disruptive Therapy Collective)
• Domenico Distefano
• Christine Dithridge
• Monica R. Dittrich, MFT
• Rae Ditty, BCBA
• Donald M. Ditullio, D.D.S.
• Gunjeeta Diwaker, DDS
• Priyadarshini Girish Diwan, DPT

• Psychiatry Physician in San Jose, CA
• Providers in San Jose, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2008; 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.