Individual provider Active NPI

Susan E Mackinnon, MD

  • Neurological Surgery Physician
  • Saint Louis, MO
National Provider Identifier
1811913130
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
102027 Issued in MO
Practice address
4921 Parkview PL
Div Surg Plastics, Ste 6G
Saint Louis, MO 63110-1032
Phone
(314) 362-7388
Fax
(833) 301-0853
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery of the Hand (Surgery) Physician 2086S0105X 102027 MO
Plastic and Reconstructive Surgery Physician 2086S0122X 102027 MO
Neurological Surgery Physician 207T00000X 102027 MO Primary

Addresses

Primary practice location

4921 Parkview PL
Div Surg Plastics, Ste 6G
Saint Louis, MO 63110-1032

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 362-7388

Other identifiers 1

IdentifierTypeStateIssuer
203098306MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20100125000476 MO Practitioner - Plastic and Reconstructive Surgery 8325130461 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

4921 Parkview PL
Suite G6TH
Saint Louis, MO 63110-1032
Phone (314) 362-7388

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
102027MOMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University CurrentSince Jan 1, 1992 Accepting new patients
Washington University CurrentSince Jan 1, 1992 Accepting new patients
Washington University Past Accepting new patients
Ozarks Medical Center Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

2 Progress Point Pkwy
O Fallon, MO 63368
Phone (636) 344-1000

4921 Parkview Pl
Ste 6G
Saint Louis, MO 63110
Phone (314) 362-7388

1 Barnes Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-9170

660 S Euclid Ave
Saint Louis, MO 63110

660 S Euclid Ave
#C
Saint Louis, MO 63110

660 S Euclid Ave
#8238
Saint Louis, MO 63110
Phone (314) 362-7388

660 S Euclid Ave
#8109
Saint Louis, MO 63110
Phone (314) 362-7841

Interoperability endpoints

  • Direct secure messaging: smackinnon154815@direct.carenet.org

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1811913130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-362-7388",
            "fax_number": "833-301-0853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 PARKVIEW PL",
            "address_2": "DIV SURG PLASTICS, STE 6G",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101032",
            "telephone_number": "314-362-7388",
            "fax_number": "833-301-0853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKINNON",
        "first_name": "SUSAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0105X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgery of the Hand",
            "state": "MO",
            "license": "102027",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MO",
            "license": "102027",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MO",
            "license": "102027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203098306",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "4921 Parkview Pl",
            "address_2": "Div Surg Plastics, Ste 6G",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.