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SUSANA QUEZADA
NPI 1043042112
Nurse Practitioner - Family in Oakland, CA

Active since August 16, 2024PECOS Enrolled
2629 KINGSLAND AVE, OAKLAND, CA 94619(818) 400-3410 Get Directions Write a Review

NPPES record last updated: August 16, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Susana Quezada NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUSANA QUEZADA (NPI 1043042112) is an individual family provider in Oakland, California, licensed in California (95029472) and active in the NPI registry since August 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1043042112
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSUSANA QUEZADA
Location Address2629 KINGSLAND AVEOakland, CA 94619-3219
Mailing Address2629 Kingsland AveOakland, CA 94619-3219 · (818) 400-3410
Phone(818) 400-3410
Sole ProprietorYes
Enumeration DateAugust 16, 2024
NPPES CertifiedAugust 16, 2024
✔ NPI 1043042112 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · 95029472
2629 KINGSLAND AVE, Oakland, CA 94619
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Susana Quezada is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Susana Quezada reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Bass Medical Group
8.0 mi
Orthopaedic Surgery
19842 LAKE CHABOT RD
Castro Valley, CA 94546
  • Reassigned Medicare billing, California enrollment
  • 347 clinicians in this Medicare group
NPI 1093181646 (510) 886-8844
Pacific Heights Medical Group
13 mi
Internal Medicine
2340 CLAY ST, SIXTH FLOOR
San Francisco, CA 94115
  • Reassigned Medicare billing, California enrollment
  • 14 clinicians in this Medicare group
NPI 1376693200 (415) 674-5223

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94619 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$104.51 typical visit price
range $69.00 – $202.35
Typical copayment $26.12 (range $17.25 – $50.58)
Most-billed visit code 99203
Established Patient
$119.48 typical visit price
range $23.44 – $166.46
Typical copayment $29.87 (range $5.86 – $41.61)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Susana Quezada's NPI number?

The NPI number for Susana Quezada is 1043042112. It was assigned to this individual provider in the NPPES registry on August 16, 2024.

Where is Susana Quezada located?

Susana Quezada practices at 2629 Kingsland Ave, Oakland, CA 94619. The listed phone number is (818) 400-3410.

What is Susana Quezada's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Susana Quezada enrolled in Medicare?

Yes. Susana Quezada is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Susana Quezada's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Susana Quezada reassigns Medicare benefits to 2 organizations: Bass Medical Group (Castro Valley, CA) and Pacific Heights Medical Group (San Francisco, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Susana Quezada's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Susana Quezada was last updated on August 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.