Theresa Suozzi, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01072785A Issued in IN

Practice address

2040 N Shadeland Ave Ste 250
Indianapolis, IN 46219-1712

Phone

(317) 355-5009

NPI assigned

Apr 17, 2009

Last updated

Nov 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Other names 1

• Theresa Hansen Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Family Practice

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health Network IncGroup PAC ID 1850203977, 95 clinicians

Hope Recovery Kokomo LLCGroup PAC ID 4880062488, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Hospital East Hospital, Indianapolis, IN, CCN 150074

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tsuozzi115625@ecommunitydirect.com

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.

• Community Health Network, Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1336119478
  Medicare reassignment Care Compare group NPD
• Hope Recovery Kokomo, LLC

  dba Wabash Recovery

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Kokomo, IN
  • NPI 1710587910
  Medicare reassignment Care Compare group NPD
• Community Physicians of Indiana Inc

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1619105244
  Medicare reassignment NPD
• Restored Life Health Network

  • Multi-Specialty Clinic/Center
  • Kokomo, IN
  • NPI 1487430864

  Family Medicine

  Medicare reassignment NPD
• Community Health Network, Inc

  dba Community Fairbanks Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Indianapolis, IN
  • NPI 1265477632
  NPD
• Community Physicians of Indiana Inc

  dba Community Physician Network

  • Endocrinology, Diabetes & Metabolism Physician
  • Carmel, IN
  • NPI 1992396337
  NPD
• Hope Recovery Kokomo, LLC

  dba Wabash Recovery

  • Substance Abuse Rehabilitation Facility
  • Kokomo, IN
  • NPI 1457041774
  NPD
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)
• Hartford Physician Services PC

  dba Hartford Medical Group

  • Internal Medicine Physician
  • Hartford, CT
  • NPI 1164404117

  Family Medicine

  NPD (past)

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

• Community Health Network, Inc

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1336119478
  Care Compare affiliation

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

{
    "created_epoch": "1239926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1952544199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E. 75TH STREET",
            "address_2": "SUITE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 N SHADELAND AVE STE 250",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462191712",
            "telephone_number": "317-355-5009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5545 E Stop 11 Rd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462378616",
            "country_code": "US",
            "telephone_number": "317-497-6800",
            "fax_number": "317-497-6801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2040 N Shadeland Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462191727",
            "country_code": "US",
            "telephone_number": "317-355-1800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUOZZI",
        "first_name": "THERESA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-17",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "048872",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "45999",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01072785A",
            "primary": true
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "IN",
            "license": "01072785A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01347744",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201202360",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004236346",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tsuozzi115625@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Health Network, Inc",
            "address_1": "6950 Hillsdale Ct",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462502040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "HANSEN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sunrise Homecare LLC
• Sunrise Residential Care LLC
• Sunstar Transtationllc
• Sunstars ABA in LLC
• Brent A Suozzi, MD
• Nucharin Supakul, M.D.
• Andrea Nicole Supe, P.T.
• Superior Elegance Care LLC
• Superior Home Care Serivces LLC
• Superior Van & Mobility

• Family Medicine Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.