Individual provider Active NPI

Susan Ann McCartan, M.D.

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1790713576
Registry record updated Jan 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
24901 Issued in AZ
Practice address
1300 S. 10 Street
Wesley Community & Health Center
Phoenix, AZ 85034
Phone
(602) 368-9603
Fax
(602) 257-4338
NPI assigned
Jun 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 24901 AZ Primary

Addresses

Primary practice location

1300 S. 10 Street
Wesley Community & Health Center
Phoenix, AZ 85034

Mailing address

1300 S 10TH St
Phoenix, AZ 85034-4516
Phone (602) 252-5609

Other identifiers 1

IdentifierTypeStateIssuer
427907MedicaidAZ

Other names 1

  • Susan Ann Kaib Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24901AZMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358812800000",
    "number": "1790713576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 S 10TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850344516",
            "telephone_number": "602-252-5609",
            "fax_number": "602-257-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S. 10 STREET",
            "address_2": "WESLEY COMMUNITY & HEALTH CENTER",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85034",
            "telephone_number": "602-368-9603",
            "fax_number": "602-257-4338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTAN",
        "first_name": "SUSAN",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2013-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "24901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "427907",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "KAIB",
            "middle_name": "ANN",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.