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SUSANE A. DICKSON M.D.
NPI 1194804054
Psychiatry & Neurology - Child & Adolescent Psychiatry in Riverside, RI

Active since November 03, 2006PECOS Enrolled
1011 VETERANS MEMORIAL PKWY, RIVERSIDE, RI 02915(401) 432-1000(401) 432-1500 Get Directions Write a Review

NPPES record last updated: August 20, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 20, 2020, Apr 15, 2019, Nov 15, 2018 (3 updates tracked since 2018).

About Susane A. Dickson M.d. NPPES

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

SUSANE A. DICKSON M.D. (NPI 1194804054) is an individual child & adolescent psychiatry provider in Riverside, Rhode Island, licensed in Rhode Island (MD17188) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1194804054
Entity TypeIndividualFemale
Primary Taxonomy2084P0804X
Provider Legal NameSUSANE A. DICKSONCredential: M.D.
Location Address1011 VETERANS MEMORIAL PKWYRiverside, RI 02915-5061
Mailing Address117 Ellenfield St Ste 101Providence, RI 02905-4541 · (014) 444-6779 · Fax (401) 444-6912
Phone(401) 432-1000
Fax(401) 432-1500
Sole ProprietorYes
Enumeration DateNovember 3, 2006
Last NPPES UpdateAugust 20, 20203 updates tracked since enumeration
NPPES CertifiedAugust 20, 2020
✔ NPI 1194804054 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
License✔ Licensed in RI · MD17188
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
Also ListedPediatricsTaxonomy 208000000X · License ME71623 (FL), 264742 (MA)
1011 VETERANS MEMORIAL PKWY, Riverside, RI 02915
Open in Google Maps ↗

Secondary Practice Locations 2

Location 11364 Clifton Rd NEAtlanta, GA 30322-1059 · Phone (404) 727-5157 · Fax (404) 727-4746
Location 263 Main StBrockton, MA 02301-4042 · Phone (508) 559-6699

Other Identifiers 1

Medicaid258302000FL

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Susane A. Dickson M.d. 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

4

Medicare enrollment records show Susane Dickson reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Gateway Healthcare Inc
5.5 mi
Mental Health (Including Community Mental Health Center)
101-103 BACON ST
Pawtucket, RI 02860
  • Reassigned Medicare billing, Rhode Island enrollment
  • 150 clinicians in this Medicare group
NPI 1821078932 (401) 722-3560
Learnwell Behavioral Health LLC
38 mi
Adolescent and Children Mental Health
2A MAIN STREET
Plymouth, MA 02360
  • Reassigned Medicare billing, Massachusetts enrollment
  • 7 clinicians in this Medicare group
NPI 1265134001 (508) 562-2477
Cape Cod Healthcare Inc.
57 mi
Mental Health (Including Community Mental Health Center)
460 W MAIN ST
Hyannis, MA 02601
  • Reassigned Medicare billing, Massachusetts enrollment
  • 25 clinicians in this Medicare group
NPI 1245286152 (508) 790-3360
Physicians Of Cape Cod Hospital
57 mi
Neuroradiology
27 PARK ST
Hyannis, MA 02601
  • Reassigned Medicare billing, Massachusetts enrollment
  • 678 clinicians in this Medicare group
NPI 1679832364 (508) 957-8667

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

Other Providers at the Same Location NPPES 20

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

JUSTYNA PIASECKA M.D.
Psychiatry & Neurology (Child & Adolescent Psychiatry)
1011 VETERANS MEMORIAL PKWY
RIVERSIDE, RI 02915
Providence County (401) 432-1000
DR. VAMSI C TUMMALACHETTY PSYD
Psychologist (Clinical)
1011 VETERANS MEMORIAL PKWY
RIVERSIDE, RI 02915
Providence County (401) 432-1000
MOLLIE BURNS LCSW
Social Worker (Clinical)
1011 VETERANS MEMORIAL PKWY
RIVERSIDE, RI 02915
Providence County (401) 432-1000
ELISE TAVERNA
Psychologist (Clinical)
1011 VETERANS MEMORIAL PKWY
RIVERSIDE, RI 02915
Providence County (401) 432-1000
MARIA S REGAN MSW
Social Worker (Clinical)
1011 VETERANS MEMORIAL PKWY
EAST PROVIDENCE, RI 02915
Providence County (401) 432-1160
DR. ORNELLA JUDITH POTTER MD
Psychiatry & Neurology (Child & Adolescent Psychiatry)
1011 VETERANS MEMORIAL PKWY
RIVERSIDE, RI 02915
Providence County (401) 432-1000
DR. ANDREA LILLIAN GOLD PH.D.
Psychologist (Clinical)
1011 VETERANS MEMORIAL PKWY
RIVERSIDE, RI 02915
Providence County (401) 432-1000
TANUJA P GANDHI M.D.
Psychiatry & Neurology (Child & Adolescent Psychiatry)
1011 VETERANS MEMORIAL PKWY
RIVERSIDE, RI 02915
Providence County (401) 432-1000

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 Susane Dickson's NPI number?

The NPI number for Susane Dickson is 1194804054. It was assigned to this individual provider in the NPPES registry on November 3, 2006.

Where is Susane Dickson located?

Susane Dickson practices at 1011 Veterans Memorial Pkwy, Riverside, RI 02915. The listed phone number is (401) 432-1000.

What is Susane Dickson's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Susane Dickson enrolled in Medicare?

Yes. Susane Dickson is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Susane Dickson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Susane Dickson reassigns Medicare benefits to 4 organizations: Gateway Healthcare Inc (Pawtucket, RI), Learnwell Behavioral Health LLC (Plymouth, MA), Cape Cod Healthcare Inc. (Hyannis, MA) and Physicians Of Cape Cod Hospital (Hyannis, MA). 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 Susane Dickson'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 Susane Dickson was last updated on August 20, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.