Susan Annette Abruzzino, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

Louis a Johnson Vamc
1 Medical Center Drive
Bridgeport, WV 26301

Phone

(304) 623-7682

NPI assigned

Jul 9, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912930298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 CARRIAGE LN",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301346",
            "telephone_number": "304-623-7682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LOUIS A JOHNSON VAMC",
            "address_2": "1 MEDICAL CENTER DRIVE",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "26301",
            "telephone_number": "304-623-7682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRUZZINO",
        "first_name": "SUSAN",
        "middle_name": "ANNETTE",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Physician Assistant in Bridgeport, WV
• Providers in Bridgeport, WV by specialty
• Medical Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.