Susan Ouellette, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0386509 Issued in MA

Practice address

2124 Ramona LN
Woodstock, MD 21163-1248

Phone

(410) 236-9951

NPI assigned

Oct 27, 2006

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

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MD, CT, DC, MA, WA5 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 5

Specialty

Nurse Practitioner

Education

University of Maryland School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Lifebridge Community Physicians IncGroup PAC ID 3678751468, 183 clinicians

Triumph Behavioral Health LLCGroup PAC ID 9739470667, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwest Hospital Center Hospital, Randallstown, MD, CCN 210040
• Medstar Harbor Hospital Hospital, Baltimore, MD, CCN 210034

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations (25 of 27)

Interoperability endpoints

• Direct secure messaging: pivotcare.susanouellette@160914.advancedmd-direct.com
• FHIR API: https://api.platform.athenahealth.com/17431/brand/1/csg/1/fhir/r4

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.

• Lifebridge Community Physicians, Inc

  • Cardiovascular Disease Physician
  • Timonium, MD
  • NPI 1174815807
  Medicare reassignment Care Compare group NPD
• Medstar Medical Group II LLC

  • General Practice Physician
  • Baltimore, MD
  • NPI 1184046187
  Medicare reassignment Care Compare group NPD
• Triumph Behavioral Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Catonsville, MD
  • NPI 1376999581
  Medicare reassignment Care Compare group NPD
• Carroll Health Group, LLC

  • Internal Medicine Physician
  • Westminster, MD
  • NPI 1437473550
  Medicare reassignment NPD
• Sheppard Pratt Physicians, P.a.

  • Psychiatry Physician
  • Baltimore, MD
  • NPI 1518990712
  Medicare reassignment NPD
• Sinai Hospital of Baltimore Inc

  • Surgical Critical Care Physician
  • Baltimore, MD
  • NPI 1043235666
  Medicare reassignment NPD
• Catholic Charities of Fairfield County Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Danbury, CT
  • NPI 1205050606
  Medicare reassignment NPD
• Legacy Salmon Creek Hospital

  • Clinic/Center
  • Vancouver, WA
  • NPI 1356357784
  Medicare reassignment NPD
• Pivotcare, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Duxbury, MA
  • NPI 1679211833
  Medicare reassignment NPD
• Trinity Health of New England Provider Network Organization Inc

  • Internal Medicine Physician
  • Hartford, CT
  • NPI 1003882812
  Medicare reassignment NPD
• Washington Hospital Center Corp

  • Neurological Surgery Physician
  • Washington, DC
  • NPI 1407870124
  Medicare reassignment NPD
• Westborough Behavioral Healthcare Hospital, LLC

  • Psychiatry Physician
  • Westborough, MA
  • NPI 1821565425
  Medicare reassignment NPD

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

• Harbor Hospital, Inc.

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1720175623
  Care Compare affiliation
• Northwest Hospital Center, Inc.

  • General Acute Care Hospital
  • Randallstown, MD
  • NPI 1487695888
  Care Compare affiliation

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1720164320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 RAMONA LN",
            "city": "WOODSTOCK",
            "state": "MD",
            "postal_code": "211631248",
            "telephone_number": "410-236-9951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 RAMONA LN",
            "city": "WOODSTOCK",
            "state": "MD",
            "postal_code": "211631248",
            "telephone_number": "410-236-9951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4050 Coon Rapids Blvd NW",
            "address_purpose": "LOCATION",
            "city": "Coon Rapids",
            "state": "MN",
            "postal_code": "554332522",
            "country_code": "US",
            "telephone_number": "612-262-1220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1700 Medical Center Pkwy",
            "address_purpose": "LOCATION",
            "city": "Murfreesboro",
            "state": "TN",
            "postal_code": "371292245",
            "country_code": "US",
            "telephone_number": "615-396-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OUELLETTE",
        "first_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "00000",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "003720",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R117618",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "36255",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "0386509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "61087301-PR31",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "772103000",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "M644-0001",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "537442000",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER URBAN BEHAVIORAL ASSOCIATES",
            "identifier": "015LM670",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walter Matthew Mazzella, DDS
• Michelle Morrison and Associates
• Monarch Wellness and Counseling Services
• Michelle Marie Morrison
• Robert William Nagle
• Lauren Rebecca Pantoulis, M.S.
• Ashish Patel
• Devaki Patel, PHARMD
• Playful Peaks, ABA
• Positive Outcomes Counseling & Consulting, LLC

• Psychiatric/Mental Health Nurse Practitioner in Woodstock, MD
• Providers in Woodstock, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; 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.