Susan Czelusta, CNM
Individual provider Active NPI Advanced Practice Midwife · Divide, CO
NPI 1831646678 · NPPES record last updated Sep 9, 2016
Key facts
- NPI
- 1831646678
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Advanced Practice Midwife 367A00000X
- License
- APN.0992514-CNM (CO)
- Practice address
- 408 Silvermoon HTS
Divide, CO 80814-9256 - Phone
- (501) 850-5514
- NPI assigned
- Sep 9, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Certified Nurse Midwife (CNM)
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Poudre Valley Medical Group LLC
Practice addresses (Care Compare)
1501 Court St
Pueblo, CO 81003-2720
Phone (719) 543-6755
4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180822002597 | CO | Practitioner - Certified Nurse Midwife (CNM) | 5395094452 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Midwife
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Poudre Valley Medical Group, LLC | Current |
Accepting new patients | |
| Poudre Valley Medical Group, LLC | Current |
Accepting new patients | |
| Parkview Medical Center, Inc. | Past | Accepting new patients |
Locations
4404 Barranca Ln
Unit 101
Castle Rock, CO 80104
Phone (720) 733-5260
4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260
4010 Jerry Murphy Rd
Pueblo, CO 81001
Phone (719) 546-2229
1600 N Grand Ave
Ste 400
Pueblo, CO 81003
Phone (719) 543-4000
1120 Minnequa Ave
Pueblo, CO 81004
Phone (719) 281-3285
1619 N Greenwood St
Ste 106
Pueblo, CO 81003
Phone (719) 595-7760
400 W 16th St
Pueblo, CO 81003
Phone (719) 584-4000
1501 Court St
Pueblo, CO 81003
Phone (719) 543-6755
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | APN.0992514-CNM | CO | Yes |
Addresses
Primary practice location
408 Silvermoon HTS
Divide, CO 80814-9256
Mailing address
408 Silvermoon HTS
Divide, CO 80814-9256
Phone (501) 850-5514
Other providers in Divide, CO
- Lorraine Agold-Rich
- Ellen Andrew
- Lisa Bradley
- Joy Ann Buckley
- Miranda Jo David
- George V Drake
- Carol Flowers
- Kathy Marie Hall
- Richard D Haugen
All providers in Divide, CO · Advanced Practice Midwife in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.