Individual provider Active NPI

Susan A Martin, PSYD

  • Psychologist
  • Phoenix, AZ
National Provider Identifier
1992868020
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3847 Issued in AZ
Practice address
2927 N 7TH Ave
Phoenix, AZ 85013-4102
Phone
(602) 406-3153
Fax
(602) 406-4122
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
No

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
Psychologist 103T00000X 3847 AZ Primary

Addresses

Primary practice location

2927 N 7TH Ave
Phoenix, AZ 85013-4102

Mailing address

3200 N Central Ave
Suite 900
Phoenix, AZ 85012-2425
Phone (602) 406-3729

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230914002442 MI Practitioner - Clinical Psychologist 7810091824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Bay RegionGroup PAC ID 5597659011, 110 clinicians

Practice addresses (Care Compare)

1900 Columbus Ave
Bay Regional
Bay City, MI 48708-6831
Phone (989) 894-3278

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3847AZMDCommunity Health Worker

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Bay Region CurrentSince Sep 5, 2023 Accepting new patients
McLaren Bay Region Psychologist CurrentSince Sep 5, 2023 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000

2940 Health Pkwy
Mt Pleasant, MI 48858
Phone (989) 466-2877

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992868020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 N CENTRAL AVE",
            "address_2": "SUITE 900",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122425",
            "telephone_number": "602-406-3729",
            "fax_number": "602-798-9412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2927 N 7TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134102",
            "telephone_number": "602-406-3153",
            "fax_number": "602-406-4122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "SUSAN",
        "middle_name": "A",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "3847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.