Individual provider Active NPI

Susan Helen Dorski, PHD

  • Clinical Psychologist
  • Beachwood, OH
National Provider Identifier
1750499075
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3323 Issued in OH
Practice address
3619 Park East Dr
Suite 313
Beachwood, OH 44122-4330
Phone
(216) 591-0500
Fax
(216) 591-0550
NPI assigned
Aug 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3323 OH Primary

Addresses

Primary practice location

3619 Park East Dr
Suite 313
Beachwood, OH 44122-4330

Mailing address

3619 Park East Dr
Suite 313
Beachwood, OH 44122-4330
Phone (216) 591-0500

Other identifiers 3

IdentifierTypeStateIssuer
000000353722OtherOHANTHEM
2518716MedicaidOH
P00146602OtherOHRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041005000523 OH Practitioner - Clinical Psychologist 1557320728 Reassigns benefits to 1 organization
Practice locations: Bellevue, OH; Castalia, OH

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

9912 State RT
Suite 4
Castalia, OH 44824
Phone (419) 483-9228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3323OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Transitions, Inc Clinical CurrentSince Jan 21, 2009 Accepting new patients

Locations

3619 Park East Dr
Ste 313
Beachwood, OH 44122
Phone (216) 591-0500

3872 E Harbor Light Landing Dr
Port Clinton, OH 43452
Phone (419) 734-3333

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750499075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3619 PARK EAST DR",
            "address_2": "SUITE 313",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224330",
            "telephone_number": "216-591-0500",
            "fax_number": "216-591-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3619 PARK EAST DR",
            "address_2": "SUITE 313",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224330",
            "telephone_number": "216-591-0500",
            "fax_number": "216-591-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORSKI",
        "first_name": "SUSAN",
        "middle_name": "HELEN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "3323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000353722",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2518716",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00146602",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

Verify at the official NPI Registry.