Individual provider Active NPI

Suzanne Marie Echemendia-Wirth, M.D.

  • Emergency Medicine Physician
  • Bronx, NY
National Provider Identifier
1962590778
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
236387 Issued in NY
Practice address
1650 Grand Concourse
Bronx, NY 10457-7606
Phone
(718) 518-5046
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 236387 NY Primary

Addresses

Primary practice location

1650 Grand Concourse
Bronx, NY 10457-7606

Mailing address

22 Jones St Apt 4F
New York, NY 10014-4144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20130426000622 SC Practitioner - Emergency Medicine 6800817610 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Medical University of South Carolina College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SC Professional Services LLCGroup PAC ID 5991233397, 4 clinicians
Mount Pleasant Emergency Physicians, LLCGroup PAC ID 9537343033, 13 clinicians

Practice addresses (Care Compare)

1064 Gardner Rd
Suite 215
Charleston, SC 29407-1712
Phone (843) 737-0312

2000 Hospital Dr
Mount Pleasant, SC 29464-3764
Phone (843) 881-0100

Hospital & facility affiliations

  • Novant Health East Cooper Medical Center Hospital, Mount Pleasant, SC, CCN 420089

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
236387NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Pleasant Emergency Physicians, LLC Emergency Medicine CurrentSince Dec 15, 2024 Accepting new patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine CurrentSince May 1, 2016 Accepting new patients
SC Professional Services, LLC CurrentSince Sep 19, 2024 Accepting new patients
Montefiore Mount Vernon Hospital Past Accepting new patients

Locations

1064 Gardner Rd
Ste 215
Charleston, SC 29407
Phone (843) 737-0312

2000 Hospital Dr
Mt Pleasant, SC 29464
Phone (803) 533-2200

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

501 Robertson Blvd
Walterboro, SC 29488
Phone (843) 549-2000

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 and National Provider Directory roles.

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962590778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 JONES ST APT 4F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100144144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104577606",
            "telephone_number": "718-518-5046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECHEMENDIA-WIRTH",
        "first_name": "SUZANNE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "236387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.