Individual provider Active NPI

Susan A. Winchell, MD

  • Pediatrics Physician
  • Wharton, TX
National Provider Identifier
1790749513
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
H1428 Issued in TX
Practice address
2112 Regional Medical Dr Ste 1313
Wharton, TX 77488-1413
Phone
(979) 543-2956
Fax
(979) 543-6756
NPI assigned
Apr 17, 2006
Last updated
Feb 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X H1428 TX Primary

Addresses

Primary practice location

2112 Regional Medical Dr Ste 1313
Wharton, TX 77488-1413

Mailing address

101 Avenue F N
Bay City, TX 77414-3167
Phone (979) 245-2008

Other identifiers 1

IdentifierTypeStateIssuer
126192709MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.athenanet.athenhealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100726000373 TX Practitioner - Pediatric Medicine 1153453220 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H1428TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Matagorda Episcopal Health Outreach Program CurrentSince Sep 1, 2020 Accepting new patients
Matagorda Episcopal Health Outreach Program Corporation CurrentSince Sep 1, 2020 Accepting new patients
Matagorda Episcopal Health Outreach Program Past Accepting new patients
South Texas Medical Clinics, P.a. Past Accepting new patients
Matagorda Episcopal Health Outreach Program PastSince Aug 25, 2019 Accepting new patients
South Texas Medical Clinics, P.a. Past Accepting new patients
Matagorda Episcopal Health Outreach Program Past Accepting new patients

Locations

101 Avenue F N
Bay City, TX 77414

111 Avenue F
Bay City, TX 77414
Phone 9792452008300

307 Green Ave
Ste A
Palacios, TX 77465
Phone 9792452008300

2112 Regional Medical Dr
Ste 1313
Wharton, TX 77488
Phone 9792452008300

2112 Regional Medical Dr
Ste 1317
Wharton, TX 77488
Phone 9792452008300

Interoperability endpoints

  • Direct secure messaging: susan.winchell.1@17406.direct.athenahealth.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1790749513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 AVENUE F N",
            "city": "BAY CITY",
            "state": "TX",
            "postal_code": "774143167",
            "telephone_number": "979-245-2008",
            "fax_number": "979-314-7164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 REGIONAL MEDICAL DR STE 1313",
            "city": "WHARTON",
            "state": "TX",
            "postal_code": "774881413",
            "telephone_number": "979-543-2956",
            "fax_number": "979-543-6756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINCHELL",
        "first_name": "SUSAN",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "H1428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126192709",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.athenanet.athenhealth.com",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Cloud",
            "address_1": "2112 Regional Medical Dr Ste 1313",
            "city": "Wharton",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774881413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wharton, TX

Sources for this page

Verify at the official NPI Registry.