Susan E Mannan, M.D.

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

C7-0003656 Issued in DE

Practice address

3903-A Fair Ridge Dr.
Fairfax, VA 22033

Phone

(703) 648-0030

Fax

(703) 648-9028

NPI assigned

Mar 8, 2007

Last updated

Nov 24, 2014By 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 1

Addresses

Other names 1

• Dr. Susan E Hodgdon Former name

Medicare fee-for-service enrollment

Enrolled in DC, VA2 enrollments

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 2

Specialty

Allergy/Immunology

Education

Eastern Virginia Medical School, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
• Direct secure messaging: susan.mannan.1@8042.direct.athenahealth.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.

• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480

  Allergy & Immunology, DC

  Medicare reassignment Care Compare group NPD
• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD
• Nova Physician Wellness Center PLLC

  • Family Medicine Physician
  • Fairfax, VA
  • NPI 1215307400
  NPD (past)

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416787200000",
    "number": "1982735437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3903-A FAIR RIDGE DRIVE",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22033",
            "telephone_number": "703-648-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903-A FAIR RIDGE DR.",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22033",
            "telephone_number": "703-648-0030",
            "fax_number": "703-648-9028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNAN",
        "first_name": "SUSAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2014-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "DE",
            "license": "C7-0003656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "HODGDON",
            "middle_name": "E",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wien Manguerra-Casiano, D.O.
• Alex Dertad Manguikian, M.D., PH.D.
• Kanan D Maniar, M.D.
• Timothy Patrick Manley, M.S.W.
• Lauryn Mann
• Laura Jean Manning, MA, CCC-SLP
• Skylar Manning, DPT
• Anup Manoharan, M.D.
• Manor Care-Fair Oaks of Fairfax VA LLC (ProMedica Skilled Nursing and Rehabilitation (Fair Oaks))
• Sandra M Mansfield, LCSW

• Allergy & Immunology Physician in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Allergy & Immunology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2014; 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.