Susan Marie St Pierre, DO

Primary specialty

Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X

License

1409 Issued in ME

Practice address

1615 Hill Rd Ste 14
Novato, CA 94947

Phone

(415) 895-1441

Fax

(415) 895-1288

NPI assigned

Oct 6, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

Other names 1

• Susan Marie Shea Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, 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 and National Provider Directory roles.

• Susan Marie Stpierre, DO Inc

  • Family Medicine Physician
  • Novato, CA
  • NPI 1336613504
  NPD Authorized official
• Thomas P Young PHD NP PC

  • Addiction (Substance Use Disorder) Registered Nurse
  • Novato, CA
  • NPI 1508416389
  NPD (past)

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1720076458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 SCAMMON ST STE 19-200",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040725121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 HILL RD STE 14",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "94947",
            "telephone_number": "415-895-1441",
            "fax_number": "415-895-1288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 Redwood Highway",
            "address_2": "Suite 246",
            "address_purpose": "LOCATION",
            "city": "Mill Valley",
            "state": "CA",
            "postal_code": "94941",
            "country_code": "US",
            "telephone_number": "415-388-2360",
            "fax_number": "415-968-6620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ST PIERRE",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-06",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A14943",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "1409",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "ME",
            "license": "1409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34330534",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "48178845",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "796386",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "243530099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "SHEA",
            "middle_name": "MARIE",
            "credential": "DO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Addiction Medicine (Preventive Medicine) Physician in Novato, CA
• Providers in Novato, CA by specialty
• Addiction Medicine (Preventive Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; 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.