Susan E Sue, P.T

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT10806 Issued in CA

Practice address

9909 Mira Mesa Blvd
Ste. 120
San Diego, CA 92131-1056

Phone

(858) 693-0436

Fax

(858) 693-0437

NPI assigned

May 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Washington School of Medicine, 1981

Medicare assignment

May accept Medicare assignment

Group practices

Barbara Jean Boutelle Carlsbad Physical TherapyGroup PAC ID 4082527189, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Barbara Jean Boutelle Carlsbad Physical Therapy

  • Physical Therapist
  • Carlsbad, CA
  • NPI 1669420980
  Medicare reassignment Care Compare group NPD
• Barbara Jean Boutelle Carlsbad Physical Therapy

  • Physical Therapist
  • Oceanside, CA
  • NPI 1255007050
  NPD
• Barbara Jean Boutelle Carlsbad Physical Therapy

  • Physical Therapist
  • Santee, CA
  • NPI 1730138074
  NPD
• Barbara Jean Boutelle Carlsbad Physical Therapy

  • Physical Therapist
  • San Diego, CA
  • NPI 1699723098
  NPD (past)

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1790734150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3070 MADISON ST",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920082310",
            "telephone_number": "760-591-7750",
            "fax_number": "760-294-9813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9909 MIRA MESA BLVD",
            "address_2": "STE. 120",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311056",
            "telephone_number": "858-693-0436",
            "fax_number": "858-693-0437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUE",
        "first_name": "SUSAN",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "P.T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT10806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sudhir Malik, a Professional Medical Corporation
• Justine Renae Sudlow
• Jason Sudo, PHARMD
• Sue E. Shrader,MFT
• David Sue
• Ryan T Suemoto
• Jill Suess, L.AC.
• Edil Ahmed Sufi
• Fowsiya Ahmed Sufi
• Jeffrey Paul Sugar, D.O.

• Physical Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.