NPIMap

Individual provider Active NPI

Susan M Bennett, CRNP

  • Nurse Practitioner
  • Williamsport, PA
National Provider Identifier
1750799334
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP014041 Issued in PA
Practice address
1100 Grampian Blvd
Williamsport, PA 17701-1907
Phone
(570) 326-8470
NPI assigned
Jul 28, 2014
Last updated
Feb 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP014041 PA Primary
Adult Health Nurse Practitioner 363LA2200X SP014041 PA

Addresses

Primary practice location

1100 Grampian Blvd
Williamsport, PA 17701-1907

Mailing address

1201 Grampian Blvd
Williamsport, PA 17701-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140929000673 PA Practitioner - Nurse Practitioner 5799905659 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Susquehanna Physician ServicesGroup PAC ID 2264336460, 611 clinicians

Practice addresses (Care Compare)

1100 Grampian Blvd
Williamsport, PA 17701-1907
Phone (570) 326-8470

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.06 of 100Reported as group
Quality
62.07
Promoting interoperability
100
Improvement activities
40
Cost
74.81

Merit-based Incentive Payment System (MIPS)

Final score
83.69 of 100Reported as group
Quality
75.14
Promoting interoperability
100
Improvement activities
40
Cost
70.49

Merit-based Incentive Payment System (MIPS)

Final score
79.37 of 100Reported as group
Quality
86.43
Promoting interoperability
100
Improvement activities
40
Cost
44.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP014041PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Susquehanna Physician Services CurrentSince Mar 1, 2022 Accepting new patients
Upmc Wellsboro Nurse Practitioner CurrentSince Apr 30, 2022 Accepting new patients
Charles Cole Memorial Hospital CurrentSince May 1, 2022 Accepting new patients
Upmc Wellsboro CurrentSince Apr 30, 2022 Accepting new patients
Charles Cole Memorial D/B/a Upmc Cole CurrentSince May 1, 2022 Accepting new patients
Susquehanna Physician Services Adult Health CurrentSince Mar 1, 2022 Accepting new patients
Charles Cole Memorial Hospital CurrentSince Jul 6, 2025 Accepting new patients
Susquehanna Physician Services Nurse Practitioner Past Accepting new patients

Locations

1001 E 2nd St
Coudersport, PA 16915
Phone (814) 274-7407

15 Meade St
Ste L3
Wellsboro, PA 16901
Phone (570) 723-0100

9 Water St
Ofc Of
Wellsboro, PA 16901
Phone (570) 724-2325

1100 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8005

1201 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8723

700 High St
Williamsport, PA 17701
Phone (570) 321-2000

Interoperability endpoints

  • Direct secure messaging: sbennett36958@upmc.direct-ci.com

Organizations & group practices 8

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1750799334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 GRAMPIAN BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 GRAMPIAN BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011907",
            "telephone_number": "570-326-8470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "SUSAN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-28",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP014041",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP014041",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsport, PA

Sources for this page

Verify at the official NPI Registry.