ELLA S SUSSMAN APRN
NPI 1235559428
Nurse Practitioner - Psychiatric/Mental Health in Springfield, MA
NPI Status: Active since April 26, 2014
Contact Information
110 MAPLE ST
SPRINGFIELD, MA
ZIP 01105
Phone: (413) 732-7419
- Individual
- Female
- Years of Experience 13
- Nurse Practitioner
- Psychiatric/Mental Health
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About ELLA SUSSMAN
This page provides the complete NPI Profile along with additional information for Ella Sussman, a provider established in Springfield, Massachusetts with a medical specialization in Nurse Practitioner, focusing in psychiatric/mental health and more than 13 years of experience. She graduated from Yale University School Of Medicine in 2013. The healthcare provider is registered in the NPI registry with number 1235559428 assigned on April 2014. The practitioner's primary taxonomy code is 363LP0808X with license number RN2303338 (MA). The provider is registered as an individual and her NPI record was last updated 10 years ago.
- NPI
- 1235559428
- Provider Name
- ELLA S SUSSMAN APRN
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 110 MAPLE ST SPRINGFIELD, MA 01105
- Location Phone
- (413) 732-7419
- Mailing Address
- 110 MAPLE ST SPRINGFIELD, MA 01105
- Mailing Phone
- (413) 732-7419
- Medical School Name
- YALE UNIVERSITY SCHOOL OF MEDICINE
- Graduation Year
- 2013
- Is Sole Proprietor?
- No
- Enumeration Date
- 04-26-2014
- Last Update Date
- 12-03-2015
- Code Navigator
A nurse practitioner (NP) like Ella Sussman is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Practitioner Psychiatric/Mental Health
- Taxonomy Code
- 363LP0808X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- RN2303338
- License State
- MA
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 163W00000X | Nursing Service Providers | Registered Nurse | 113557 (CT) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Access Blue New England HMO 5000/10%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 5000/20%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 6500/30%/9200 Value - HMO
- Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
- Anthem Gold Access Blue New England HMO 1000/20%/7500 - HMO
- Anthem Gold Access Blue New England HMO 2000/0%/6500 RxD - HMO
- Anthem Gold Access Blue New England HMO 2000/10%/4600 w/HSA - HMO
- Anthem Gold Access Blue New England HMO 2000/10%/7500 - HMO
- Anthem Gold Access Blue New England HMO 2000/20%/4600 w/HSA - HMO
- Anthem Gold Access Blue New England HMO 3000/0%/5500 RxD - HMO
- Anthem Gold Access Blue New England HMO 500/25%/7000 - HMO
- Anthem Platinum Access Blue New England HMO 250/10%/3500 - HMO
- Anthem Silver Access Blue New England HMO 2000/30%/9000 Value - HMO
- Anthem Silver Access Blue New England HMO 3000/20%/8500 - HMO
- Anthem Silver Access Blue New England HMO 3000/30%/9000 Value - HMO
- Anthem Silver Access Blue New England HMO 3500/20%/7250 w/HSA - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/8500 - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/8500 RxD - HMO
- Anthem Silver Access Blue New England HMO 4000/10%/7250 w/HSA - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Ella Sussman is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Ella Sussman is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 1759684475
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20160129000432
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Follow-up hospital inpatient care per day, typically 25 minutes
Initial hospital inpatient care per day, typically 50 minutes
Psychiatric diagnostic evaluation with medical services
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
This service was performed 253 times for 82 patientsInitial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
This service was performed 30 times for 29 patientsA psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.
This service was performed 53 times for 49 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $22.67 for a new patient copayment and $25.87 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 01105 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $90.7
- Minimum New Patient Price $58.86
- Maximum New Patient Price $177.36
- Average New Patient Copayment $22.67
- Minimum New Patient Copayment $14.71
- Maximum New Patient Copayment $44.34
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $103.48
- Minimum Established Patient Price $19.11
- Maximum Established Patient Price $144.84
- Average Established Patient Copayment $25.87
- Minimum Established Patient Copayment $4.77
- Maximum Established Patient Copayment $36.21
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 3 | 5 | 5 | 5 | 9 | 4 | 2 | 8 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 6 | 5 | 10 | 5 | 18 | 4 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 6 + 5 + 1 + 0 + 5 + 1 + 8 + 4 + 4 + 24 = 62 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 62 = 8 | 8 | ||||||||
The NPI number 1235559428 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
ANDREA K TOMSHO-DEXTER LICSW
Social Worker
(Clinical)
110 MAPLE ST
SPRINGFIELD, MA
ZIP 01105
MS. LYNN A ABRAHAM MA
Counselor
(Mental Health)
110 MAPLE ST
SPRINGFIELD, MA
ZIP 01105
MS. JOYCE LENNEA CARLSON LICSW
Social Worker
(Clinical)
110 MAPLE ST
SPRINGFIELD, MA
ZIP 01105
MS. LINDA R BECK MA, LSW
Counselor
(Mental Health)
110 MAPLE ST
SPRINGFIELD, MA
ZIP 01105
MR. NEIL BRICK M.A,
Counselor
(Mental Health)
110 MAPLE ST
SPRINGFIELD, MA
ZIP 01105
NICOLE R FALCONE LCSW
Social Worker
(Clinical)
110 MAPLE ST
CHILD GUIDANCE CLINIC
SPRINGFIELD, MA
ZIP 01105
MR. STEPHEN ASHTON HUME LMHC
Counselor
(Mental Health)
110 MAPLE ST
SPRINGFIELD, MA
ZIP 01105
MRS. GLADYS MERCEDES WAWRZASZEK CLINICIAN
Counselor
(Mental Health)
110 MAPLE ST
SPRINGFIELD, MA
ZIP 01105
MS. KRYSTYNA DANUTA BARGIEL
Counselor
(Mental Health)
110 MAPLE ST
CHILD GUIDANCE CLINIC
SPRINGFIELD, MA
ZIP 01105
MARY MIRIAM GRUNFELD OTR/L
Occupational Therapist
110 MAPLE ST
SPRINGFIELD, MA
ZIP 01105
JOANNE MURPHY MSW
Counselor
(Mental Health)
110 MAPLE ST
SPRINGFIELD, MA
ZIP 01105
MS. KATHLEEN ELLEN BIRON MSW
Social Worker
(Clinical)
110 MAPLE ST
CHILD GUIDANCE CLINIC
SPRINGFIELD, MA
ZIP 01105
LAURA WALLIS LICSW
Social Worker
(Clinical)
110 MAPLE ST
SPRINGFIELD, MA
ZIP 01105
QUEEN SMITH LCSW
Social Worker
(Clinical)
110 MAPLE ST
SPRINGFIELD, MA
ZIP 01105
MS. BLAKE CARY SCYOCURKA LICSW
Social Worker
(Clinical)
110 MAPLE ST
SPRINGFIELD, MA
ZIP 01105
DEBORAH LEE HUNTER LMHC
Counselor
(Mental Health)
110 MAPLE ST
SPRINGFIELD, MA
ZIP 01105
MRS. IRENE S KRAFT
Counselor
(Mental Health)
110 MAPLE ST
SPRINGFIELD, MA
ZIP 01105
LOUISE MOORE-ALLGIAER LICSW
Social Worker
(Clinical)
110 MAPLE ST
SPRINGFIELD, MA
ZIP 01105
MR. MARK STEPHEN AUGARTEN M.S.W.
Social Worker
(Clinical)
110 MAPLE ST
SUITE 101
SPRINGFIELD, MA
ZIP 01105
NANCY SIMMONS DIAS
Counselor
(Mental Health)
110 MAPLE ST
SPRINGFIELD, MA
ZIP 01105
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1235559428, enumerated as an "individual" on April 26, 2014.
The provider is located at 110 MAPLE ST SPRINGFIELD, MA 01105 and the phone number is (413) 732-7419.
Nurse Practitioner with taxonomy code 363LP0808X and a focus in Psychiatric/Mental Health.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield. Please consult your insurance carrier or call the provider to verify.
