Individual provider Active NPI

Susan Thurston, PA

  • Physician Assistant
  • Titusville, FL
National Provider Identifier
1982736120
Registry record updated Mar 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2469 Issued in FL
Practice address
1855 Knox McRae Dr
Titusville, FL 32780-5492
Phone
(321) 269-2028
Fax
(321) 264-0730
NPI assigned
Mar 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2469 FL Primary

Addresses

Primary practice location

1855 Knox McRae Dr
Titusville, FL 32780-5492

Mailing address

3300 S Fiske Blvd
Rockledge, FL 32955-4306

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3300 S Fiske Blvd
Rockledge, FL 32955-4306

Hospital & facility affiliations

  • Parrish Medical Center Hospital, Titusville, FL, CCN 100028
  • Cape Canaveral Hospital Hospital, Cocoa Beach, FL, CCN 100177
  • Holmes Regional Medical Center Hospital, Melbourne, FL, CCN 100019
  • Viera Hospital Hospital, Melbourne, FL, CCN 100315

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2469FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Health First Medical Group, LLC CurrentSince Mar 1, 2016 Accepting new patients
Health First Medical Group, LLC CurrentSince Mar 1, 2016 Accepting new patients

Locations

699 W Cocoa Beach Cswy
Ste 405
Cocoa Beach, FL 32931
Phone (321) 868-7272

7227 N US Highway 1
Ste 100
Port St John, FL 32927
Phone (321) 269-2028

3300 S Fiske Blvd
Rockledge, FL 32955
Phone (321) 434-1771

1855 Knox McRae Dr
Titusville, FL 32780
Phone (321) 269-2028

Interoperability endpoints

  • Direct secure messaging: sthurston28944@epicdirect.hf.org

Organizations & group practices 2

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 5

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": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1982736120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 KNOX MCRAE DR",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327805492",
            "telephone_number": "321-269-2028",
            "fax_number": "321-264-0730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THURSTON",
        "first_name": "SUSAN",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA2469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

Verify at the official NPI Registry.