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DR. SUSAN M. GANNON M.D.
NPI 1063471209
Specialist in Albany, NY

Active since March 17, 2006PECOS EnrolledAccepts Medicare Assignment
455 PATROON CREEK BLVD., SUITE 101, ALBANY, NY 12206(518) 438-0505(518) 438-4517 Get Directions Write a Review

NPPES record last updated: January 29, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Susan M. Gannon M.d. NPPES

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

DR. SUSAN M. GANNON M.D. (NPI 1063471209) is an individual specialist in Albany, New York, licensed in New York (234913-1) and active in the NPI registry since March 2006. She is enrolled in Medicare PECOS, is affiliated with St Peter's Hospital, and is a graduate of Albany Medical College Of Union University (1999).

NPPES Registry Identity

NPI1063471209
Entity TypeIndividualFemale
Primary Taxonomy174400000X
Provider Legal NameDR. SUSAN M. GANNONCredential: M.D.
Location Address455 PATROON CREEK BLVD., SUITE 101Albany, NY 12206
Mailing Address455 Patroon Creek Blvd., Suite 101Albany, NY 12206 · (518) 438-0505 · Fax (518) 438-4517
Phone(518) 438-0505
Fax(518) 438-4517
Sole ProprietorNo
Medical School CMSAlbany Medical College Of Union UniversityGraduated 1999
Enumeration DateMarch 17, 2006
Last NPPES UpdateJanuary 29, 2014
✔ NPI 1063471209 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in NY · 234913-1
Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

455 PATROON CREEK BLVD., Albany, NY 12206
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Other Identifiers 3

Medicaid02685936NY
Medicare ID-Type UnspecifiedRA7602NY
Medicare UPINI37204NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Susan M. Gannon M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5294765111
PECOS Enrollment IDI20050819000295
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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
37 services37 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
34 services32 patients
Punch biopsy, first skin growth 11104
A punch biopsy is a procedure where a small, circular tool is used to remove a sample of skin tissue. This is usually done to test a skin growth for potential issues. You may feel a pinch, but discomfort is minimal. The area heals quickly.
14 services14 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Peter's Hospital

Acute Care Hospitals · Albany, NY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330057
Location315 South Manning BoulevardAlbany, NY 12208 · Albany County
Emergency services Birthing friendly

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DOUGLAS M. HARGRAVE M.D.
Specialist
455 PATROON CREEK BLVD., SUITE 101
ALBANY, NY 12206
Albany County (518) 438-0505
DR. STEVEN M. LYNCH MD.
Specialist
455 PATROON CREEK BLVD., SUITE 101
ALBANY, NY 12206
Albany County (518) 438-0505

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 Susan Gannon's NPI number?

The NPI number for Susan Gannon is 1063471209. It was assigned to this individual provider in the NPPES registry on March 17, 2006.

Where is Susan Gannon located?

Susan Gannon practices at 455 Patroon Creek Blvd. Suite 101, Albany, NY 12206. The listed phone number is (518) 438-0505.

What is Susan Gannon's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Susan Gannon enrolled in Medicare?

Yes. Susan Gannon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Susan Gannon affiliated with any hospitals?

According to CMS data, Susan Gannon is affiliated with St Peter's Hospital.

When was this NPI record last updated?

The NPPES record for Susan Gannon was last updated on January 29, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.