Suzanna Logan, M.D., PH.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

76828-20 Issued in WI

Practice address

8901 W Lincoln Ave
West Allis, WI 53227-2409

Phone

(414) 328-7950

NPI assigned

Apr 12, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Pathology

Education

Northeastern Ohio University College of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Great Lakes Pathologists SCGroup PAC ID 7315850682, 55 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138
• Aurora Medical Ctr Washington County Hospital, Hartford, WI, CCN 520038
• Aurora Medical Center Hospital, Grafton, WI, CCN 520207
• Aurora Medical Center Kenosha Hospital, Kenosha, WI, CCN 520189
• Aurora Memorial Hospital Burlington Hospital, Burlington, WI, CCN 520059

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Great Lakes Pathologists SC

  • Anatomic Pathology & Clinical Pathology Physician
  • West Allis, WI
  • NPI 1689695934
  Medicare reassignment Care Compare group NPD
• A2Cl Services, LLC

  • Clinical Medical Laboratory
  • West Allis, WI
  • NPI 1710064811
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Aurora Health Care Metro, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cudahy, WI
  • NPI 1235355983

  Hospital

  Care Compare affiliation
• Aurora Health Care Metro, Inc.

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1861447179
  Care Compare affiliation
• Aurora Health Care Southern Lakes, Inc.

  • General Acute Care Hospital
  • Kenosha, WI
  • NPI 1225156888
  Care Compare affiliation
• Aurora Health Care Southern Lakes, Inc.

  • General Acute Care Hospital
  • Burlington, WI
  • NPI 1861557753
  Care Compare affiliation
• Aurora Medical Center Grafton, LLC

  • General Acute Care Hospital
  • Grafton, WI
  • NPI 1265740195
  Care Compare affiliation
• Aurora Medical Center of Washington County, Inc.

  • General Acute Care Hospital
  • Hartford, WI
  • NPI 1760420103
  Care Compare affiliation
• Aurora Medical Center of Washington County, Inc.M

  • Clinic/Center
  • Hartford, WI
  • NPI 1306056056

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1942664388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 W LINCOLN AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272409",
            "telephone_number": "414-328-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 W LINCOLN AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272409",
            "telephone_number": "414-328-7950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050001",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7744 West Blvd",
            "address_purpose": "LOCATION",
            "city": "Kent",
            "state": "OH",
            "postal_code": "442406230",
            "country_code": "US",
            "telephone_number": "801-380-3979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "SUZANNA",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-12",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "MN",
            "license": "68475",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WI",
            "license": "76828-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF WISCONSIN MEDICAL EXAMINING BOARD",
            "identifier": "76828-20",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bonnie L Litrenta, RN
• Anni Liu
• LL West Allis, LLC
• Lisa B. Lloyd
• Justin Loeper, DPT
• Long Life Pharmacy 2 LLC
• Josie Longhorn, DPT
• Jackie Loomis, RN
• Gena Lorbecki, RPH
• Bonnie June Loreti, RN

• Anatomic Pathology & Clinical Pathology Physician in West Allis, WI
• Providers in West Allis, WI by specialty
• Anatomic Pathology & Clinical Pathology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.