Individual provider Active NPI

Susan Sadick Haddow, MD

  • Family Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1992737399
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
31833 Issued in MN
Practice address
2810 Nicollet Ave
Whittier Clinic
Minneapolis, MN 55408-4708
Phone
(612) 873-6963
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 31833 MN Primary

Addresses

Primary practice location

2810 Nicollet Ave
Whittier Clinic
Minneapolis, MN 55408-4708

Mailing address

701 Park Ave
Minneapolis, MN 55415-1623
Phone (612) 873-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20080630000494 MN Practitioner - Family Practice 3375615784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Virginia Commonwealth University, School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Key CorporationGroup PAC ID 9032009238, 53 clinicians
Hennepin Healthcare System IncGroup PAC ID 4789684861, 905 clinicians

Practice addresses (Care Compare)

1394 Jackson St
Suite 201
Saint Paul, MN 55117-4630
Phone (612) 315-5866

2810 Nicollet Ave
Minneapolis, MN 55408-4708
Phone (612) 873-6963

5653 Duluth St
Golden Valley, MN 55422-4054
Phone (612) 873-6963

701 Park Ave
Minneapolis, MN 55415-1623
Phone (612) 873-6963

790 W 66TH St
Richfield, MN 55423-2203
Phone (612) 873-6963

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.67 of 100Reported as group
Quality
74.5
Promoting interoperability
100
Improvement activities
40
Cost
72.86

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hennepin Healthcare System, Inc CurrentSince Oct 3, 2012 Accepting new patients
Hennepin Healthcare System Inc CurrentSince Oct 3, 2012 Accepting new patients
Regents of the University of Minnesota Past Accepting new patients
Hennepin Faculty Associates Past Accepting new patients
University of Minnesota Physicians Past Accepting new patients

Locations

701 Park Ave
#350
Minneapolis, MN 55415
Phone (612) 873-5334

914 S 8th St
#D4
Minneapolis, MN 55404
Phone (612) 347-6450

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

2810 Nicollet Ave
Minneapolis, MN 55408
Phone (612) 545-9000

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 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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1992737399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 PARK AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151623",
            "telephone_number": "612-873-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 NICOLLET AVE",
            "address_2": "WHITTIER CLINIC",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554084708",
            "telephone_number": "612-873-6963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDOW",
        "first_name": "SUSAN",
        "middle_name": "SADICK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "31833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.