Individual provider Active NPI

Susan C. Taylor, M.D.

  • Dermatology Physician
  • Philadelphia, PA
National Provider Identifier
1962546952
Registry record updated Feb 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD031488E Issued in PA
Practice address
932 Pine St
Philadelphia, PA 19107-6128
Phone
(215) 829-6861
Fax
(215) 351-3926
NPI assigned
Feb 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD031488E PA Primary

Addresses

Primary practice location

932 Pine St
Philadelphia, PA 19107-6128

Mailing address

800 Walnut St
FL 16
Philadelphia, PA 19107-5176
Phone (215) 829-6861

Other identifiers 3

IdentifierTypeStateIssuer
150874OtherPABLUE SHIELD
2077149000OtherPAKEYSTONE HEALTH PLAN EAST
2077149000OtherPAPERSONAL CHOICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20101021000055 PA Practitioner - Dermatology 8123211273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Harvard Medical School, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

3400 Civic Ctr Blvd
Suite 1 330S
Philadelphia, PA 19104-5132
Phone (215) 662-2737

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD031488EPAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Feb 1, 2016 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group Dermatology CurrentSince Feb 1, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai Dermatology Past Accepting new patients
University of Penn - Medical Group Past Accepting new patients
St Lukes-Roosevelt Hospital Center Dermatology Past Accepting new patients

Locations

1001 Chesterbrook Blvd
Berwyn, PA 19312
Phone (610) 576-7500

800 Walnut St
Fl 16
Philadelphia, PA 19107
Phone (215) 829-0101

3400 Civic Center Blvd
Ste 1-330S
Philadelphia, PA 19104
Phone (215) 360-0909

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

235 S 8th St
Philadelphia, PA 19106
Phone (215) 543-2770

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455062400000",
    "number": "1962546952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WALNUT ST",
            "address_2": "FL 16",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075176",
            "telephone_number": "215-829-6861",
            "fax_number": "215-351-3926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "932 PINE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076128",
            "telephone_number": "215-829-6861",
            "fax_number": "215-351-3926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "SUSAN",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2016-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD031488E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "150874",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH PLAN EAST",
            "identifier": "2077149000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL CHOICE",
            "identifier": "2077149000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.