Individual provider Active NPI

Susan Rae Parks, FNP-BC

  • Nurse Practitioner
  • Lewes, DE
National Provider Identifier
1841683331
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
LG-0000819 Issued in DE
Practice address
16295 Willow Creek Rd
Lewes, DE 19958-3614
Phone
(302) 644-0999
Fax
(302) 644-3099
NPI assigned
Mar 9, 2015
Last updated
Jun 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X LG-0000819 DE Primary
Family Medicine Physician 207Q00000X LG-0000819 DE

Addresses

Primary practice location

16295 Willow Creek Rd
Lewes, DE 19958-3614

Mailing address

21094 Cool Spring Rd
Milton, DE 19968-3318
Phone (302) 448-9156

Other names 1

  • Miss Susan Rae Tobias Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150720001934 DE Practitioner - Nurse Practitioner 1759694706 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aspira HealthGroup PAC ID 4486080389, 17 clinicians

Practice addresses (Care Compare)

18068 Coastal Hwy
Lewes, DE 19958-4901
Phone (302) 567-1500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
LG-0000819DEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aspira Health Family Medicine CurrentSince May 1, 2021 Accepting new patients
Milton Enterprises, Inc Family Medicine CurrentSince Nov 22, 2020 Accepting new patients
Clinic by the Sea LLC CurrentSince May 19, 2015 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

16295 Willow Creek Rd
Lewes, DE 19958
Phone (302) 503-4200

16529 Coastal Hwy
Lewes, DE 19958
Phone (302) 644-7788

18068 Coastal Hwy
Lewes, DE 19958
Phone (302) 567-1500

90 Atlantic Ave
Ste 4
Ocean View, DE 19970
Phone (302) 745-7050

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CFAFBA
  • Direct secure messaging: susan.parks.1@22424.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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": "1425859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1841683331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21094 COOL SPRING RD",
            "city": "MILTON",
            "state": "DE",
            "postal_code": "199683318",
            "telephone_number": "302-448-9156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16295 WILLOW CREEK RD",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "199583614",
            "telephone_number": "302-644-0999",
            "fax_number": "302-644-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "SUSAN",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-09",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LG-0000819",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "LG-0000819",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "TOBIAS",
            "middle_name": "RAE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lewes, DE

Sources for this page

Verify at the official NPI Registry.