Individual provider Active NPI

Susan M Carney, MD

  • Ophthalmology Physician
  • Liberty, MO
National Provider Identifier
1861595464
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
107049 Issued in MO
Practice address
1200 Landmark Ave
Liberty, MO 64068-1051
Phone
(816) 792-1900
Fax
(816) 792-3548
NPI assigned
Sep 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 107049 MO Primary

Addresses

Primary practice location

1200 Landmark Ave
Liberty, MO 64068-1051

Mailing address

1200 Landmark Ave
Liberty, MO 64068-1051
Phone (816) 792-1900

Other identifiers 1

IdentifierTypeStateIssuer
207976317MedicaidMO

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
I20100817000238 MO Practitioner - Ophthalmology 4284638446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Missouri, Kansas City, School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northland Eye Specialists PCGroup PAC ID 3476509613, 7 clinicians
Ability KCGroup PAC ID 0143116368, 166 clinicians

Practice addresses (Care Compare)

1200 Landmark Ave
Liberty, MO 64068-1051
Phone (816) 792-1900

3011 Baltimore Ave
Kansas City, MO 64108-3403
Phone (816) 751-7832

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery34
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
107049MOMDOphthalmology Physician

Organizations & group practices 2

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861595464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 LANDMARK AVE",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640681051",
            "telephone_number": "816-792-1900",
            "fax_number": "816-792-3548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 LANDMARK AVE",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640681051",
            "telephone_number": "816-792-1900",
            "fax_number": "816-792-3548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARNEY",
        "first_name": "SUSAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "107049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207976317",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, MO

Sources for this page

Verify at the official NPI Registry.