Individual provider Active NPI

Susan Elaine Pories, M.D.

  • Surgery Physician
  • Newark, NJ
National Provider Identifier
1922055623
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
71236 Issued in MA
Practice address
Cancer Center, Surgical Oncology
205 South Orange Ave
Newark, NJ 07103
Phone
(973) 972-0670
NPI assigned
May 28, 2006
Last updated
Dec 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 71236 MA Primary

Addresses

Primary practice location

Cancer Center, Surgical Oncology
205 South Orange Ave
Newark, NJ 07103

Mailing address

185 South Orange Ave
MSB G-524
Newark, NJ 07103
Phone (973) 972-6315

Other identifiers 1

IdentifierTypeStateIssuer
3083667MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050504000373 MA Practitioner - General Surgery 0648210146
I20230215002702 NJ Practitioner - Surgical OncologyPractitioner - General Surgery 0648210146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Surgical OncologyAlso: General Surgery
Education
University of Vermont College of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

140 Bergen St
Newark, NJ 07103-2425
Phone (973) 972-9000

30 Bergen St
Newark, NJ 07107-3000
Phone (973) 972-0037

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71236MAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Associates of New Jersey Inc Surgery CurrentSince Jan 6, 2023 Accepting new patients
University Physician Associates of New Jersey Inc CurrentSince Jan 6, 2023 Accepting new patients
Dr. Susan Pories Surgery PastSince Jan 1, 1990 Accepting new patients
Dr. Susan Pories PastSince Jan 1, 1990 Accepting new patients

Locations

205 S Orange Ave
Newark, NJ 07103
Phone (973) 972-2151

30 Bergen St
#12
Newark, NJ 07107
Phone (973) 972-0037

30 Bergen St
Rm 1205
Newark, NJ 07107
Phone (973) 972-0037

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 1

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": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1922055623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 SOUTH ORANGE AVE",
            "address_2": "MSB G-524",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07103",
            "telephone_number": "973-972-6315",
            "fax_number": "973-972-6803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CANCER CENTER, SURGICAL ONCOLOGY",
            "address_2": "205 SOUTH ORANGE AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07103",
            "telephone_number": "973-972-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORIES",
        "first_name": "SUSAN ELAINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-28",
        "last_updated": "2023-12-01",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "71236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3083667",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.