Susan M Komorowski, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

056772 Issued in OH

Practice address

3533 Southern Blvd
Ste 4600
Kettering, OH 45429-1273

Phone

(937) 296-0167

Fax

(937) 297-2330

NPI assigned

Apr 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1730143835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3533 SOUTHERN BLVD",
            "address_2": "STE 4600",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291273",
            "telephone_number": "937-296-0167",
            "fax_number": "937-297-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3533 SOUTHERN BLVD",
            "address_2": "STE 4600",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291273",
            "telephone_number": "937-296-0167",
            "fax_number": "937-297-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMOROWSKI",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "056772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000009385",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0723417",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christian E. Koch, M.D.
• Sara Lynn Kocian, DO
• Archana Kodali, M.D.
• Gregory Stephen Kohls, M.D.
• Keri Kolker
• Scott David Koncal, MD
• Min Kong, PHARM. D.
• Rachel Marie Korty, NP
• Ronald J. Kossow, MD
• Matthew Adam Kowaleski, DMD

• Obstetrics & Gynecology Physician in Kettering, OH
• Providers in Kettering, OH by specialty
• Obstetrics & Gynecology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.