NPIMap

Individual provider Active NPI

Suzanne L Fussell, MD

  • Family Medicine Physician
  • Oxnard, CA
National Provider Identifier
1942394457
Registry record updated Mar 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A055383 Issued in CA
Practice address
1100 North Ventura Rd Suite 109
Oxnard, CA 93030
Phone
(805) 983-0547
Fax
(805) 983-0423
NPI assigned
Oct 2, 2006
Last updated
Mar 31, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A055383 CA Primary

Addresses

Primary practice location

1100 North Ventura Rd Suite 109
Oxnard, CA 93030

Mailing address

1100 N Ventura Rd Ste 109
Oxnard, CA 93030-3841
Phone (805) 983-0547

Other identifiers 1

IdentifierTypeStateIssuer
00A55383MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120328000817 CA Practitioner - Family Practice 6800706201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Geffen School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1100 N Ventura Rd
Oxnard, CA 93030-3841
Phone (805) 983-0547

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A055383CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Nazarene Medical Clinic Inc Current Accepting new patients
St Nazarene Medical Clinic Inc CurrentSince Jul 1, 1998 Accepting new patients
Healthwise Home Care Solutions Inc CurrentSince Jan 10, 2003 Accepting new patients
Dignity Health Past Accepting new patients
Providence Saint John's Health Center Past Accepting new patients
Dignity Health Past Accepting new patients
CHLB, LLC Past Accepting new patients
The Regents of the University of California Past Accepting new patients

Locations

2403 Atlantic Ave
Long Beach, CA 90806
Phone (562) 637-3143

1100 N Ventura Rd
Ste 109
Oxnard, CA 93030
Phone (805) 983-0547

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Healthwise Home Care Solutions IncOxnard, CA, CCN 058248 Home health agency 5% Or Greater Direct Ownership Interest (50%)
Corporate Officer (50%)
Corporate Director (50%)
W-2 Managing Employee		 Jan 10, 2003
Jan 10, 2003
May 27, 2003
May 27, 2003

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 8

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301529600000",
    "number": "1942394457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N VENTURA RD STE 109",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930303841",
            "telephone_number": "805-983-0547",
            "fax_number": "805-983-0423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 NORTH VENTURA RD SUITE 109",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "93030",
            "telephone_number": "805-983-0547",
            "fax_number": "805-983-0423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUSSELL",
        "first_name": "SUZANNE",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2011-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A055383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A55383",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

Verify at the official NPI Registry.