Individual provider Active NPI

Susan G Elner, MD

  • Ophthalmology Physician
  • Ann Arbor, MI
National Provider Identifier
1780694315
Registry record updated Mar 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
4301053649 Issued in MI
Practice address
1000 Wall Street
Ann Arbor, MI 48105-1912
Phone
(734) 764-4190
NPI assigned
Aug 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 4301053649 MI Primary

Addresses

Primary practice location

1000 Wall Street
Ann Arbor, MI 48105-1912

Mailing address

3621 S State St
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047

Other identifiers 1

IdentifierTypeStateIssuer
1921434MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20100127000466 MI Practitioner - Ophthalmology 9133261258 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 Wall St
Ann Arbor, MI 48105-1912
Phone (734) 764-4190

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Ophthalmology Current Accepting new patients
Regents of the University of Michigan Ophthalmology CurrentSince Jun 11, 2015 Accepting new patients
Regents of the University of Michigan CurrentSince Jun 11, 2015 Accepting new patients
Regents of the University of Michigan Past Accepting new patients

Locations

3621 S State St
#700
Ann Arbor, MI 48108

1000 Wall St
Ann Arbor, MI 48105
Phone (734) 763-1415

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

7500 Challis Rd
Brighton, MI 48116
Phone (734) 764-4190

Interoperability endpoints

  • Direct secure messaging: selner27972@direct.med.umich.edu

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330905600000",
    "number": "1780694315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WALL STREET",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481051912",
            "telephone_number": "734-764-4190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELNER",
        "first_name": "SUSAN",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2012-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301053649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1921434",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.