Individual provider Active NPI

Susan E. Sprau, M.D.

  • Pulmonary Disease Physician
  • Los Angeles, CA
National Provider Identifier
1811008295
Registry record updated Sep 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
G44652 Issued in CA
Practice address
200 UCLA Medical PLZ
Suite B265-29
Los Angeles, CA 90095-8344
Phone
(310) 453-3989
Fax
(310) 453-2154
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X G44652 CA Primary

Addresses

Primary practice location

200 UCLA Medical PLZ
Suite B265-29
Los Angeles, CA 90095-8344

Mailing address

PO Box 280655
Northridge, CA 91328-0655
Phone (310) 453-3989

Other identifiers 2

IdentifierTypeStateIssuer
00G446520MedicaidCA
1811008295OtherCANPI

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
I20120106000083 CA Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Geriatric MedicinePractitioner - Critical Care (Intensivists)Practitioner - Preventive MedicinePractitioner - Other (Physician) 0749370815

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G44652CAMDPulmonary Disease Physician

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": "1443052800000",
    "number": "1811008295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 280655",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913280655",
            "telephone_number": "310-453-3989",
            "fax_number": "310-453-2154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 UCLA MEDICAL PLZ",
            "address_2": "SUITE B265-29",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900958344",
            "telephone_number": "310-453-3989",
            "fax_number": "310-453-2154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPRAU",
        "first_name": "SUSAN",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "G44652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G446520",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1811008295",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.