Individual provider Active NPI

Susan K Silva, MD

  • Procedural Dermatology Physician
  • Sacramento, CA
National Provider Identifier
1780796367
Registry record updated Dec 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License
G79731 Issued in CA
Practice address
3835 J St
Sacramento, CA 95816-5520
Phone
(916) 456-0400
Fax
(916) 340-0621
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Procedural Dermatology Physician 207NS0135X G79731 CA Primary

Addresses

Primary practice location

3835 J St
Sacramento, CA 95816-5520

Mailing address

3835 J St
Sacramento, CA 95816-5520
Phone (916) 456-0400

Other identifiers 1

IdentifierTypeStateIssuer
00G797310OtherCAPIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20081230000212 CA Practitioner - Dermatology 4587726583 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G79731CAMDProcedural Dermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Laser & Skin Surgery Medical Group Inc Procedural Dermatology CurrentSince Oct 9, 2025 Accepting new patients

Locations

3835 J St
Sacramento, CA 95816
Phone (916) 456-0400

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1780796367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 J ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165520",
            "telephone_number": "916-456-0400",
            "fax_number": "916-340-0621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3835 J ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165520",
            "telephone_number": "916-456-0400",
            "fax_number": "916-340-0621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILVA",
        "first_name": "SUSAN",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "G79731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PIN",
            "identifier": "00G797310",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.