DR. SEAN ROSS SUSSMAN DO
NPI 1316468895
Family Medicine in Swedesboro, NJ

Q: What is Sean Sussman's NPI number?

The NPI number for Sean Sussman is 1316468895. It was assigned to this individual provider in the NPPES registry on July 5, 2017.

Q: What is Sean Sussman's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Sean Sussman was last updated on May 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since July 05, 2017PECOS EnrolledAccepts Medicare Assignment

40 VILLAGE GREEN DR STE B, SWEDESBORO, NJ 08085(856) 467-7360(856) 467-5959 Get Directions Write a Review

NPPES record last updated: May 15, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 15, 2023, Jul 21, 2022, Mar 13, 2021 and 1 more (4 updates tracked since 2017).

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About Dr. Sean Ross Sussman Do NPPES

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

DR. SEAN ROSS SUSSMAN DO (NPI 1316468895) is an individual family medicine provider in Swedesboro, New Jersey, licensed in New Jersey (25MB10777400) and active in the NPI registry since July 2017. He is enrolled in Medicare PECOS, is affiliated with Inspira Medical Center Mullica Hill, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1316468895

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. SEAN ROSS SUSSMANCredential: DO

Location Address40 VILLAGE GREEN DR STE BSwedesboro, NJ 08085-3253

Mailing Address40 Village Green Dr Ste BSwedesboro, NJ 08085-3253 · (856) 467-7360 · Fax (856) 467-5959

Phone(856) 467-7360

Fax(856) 467-5959

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateJuly 5, 2017

Last NPPES UpdateMay 15, 20234 updates tracked since enumeration

NPPES CertifiedMay 15, 2023

✔ NPI 1316468895 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in NJ · 25MB10777400

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

40 VILLAGE GREEN DR STE B, Swedesboro, NJ 08085

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Sean Ross Sussman Do 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 ID6901228501

PECOS Enrollment IDI20200629002008

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

Medicare enrollment records show Sean Sussman reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Inspira Health Network Urgent Care, P.C.

5.1 mi

Urgent Care

201 TOMLIN STATION ROAD, SUITE B
Mullica Hill, NJ 08062

Reassigned Medicare billing, New Jersey enrollment
Medicare enrollment name: Inspira Health Network Urgent Care PC
36 clinicians in this Medicare group

NPI 1255613329 (856) 423-8666

Inspira Health Network Medical Group, P.C.

13 mi

Multi-Specialty

1120 DELSEA DR N
Glassboro, NJ 08028

Reassigned Medicare billing, New Jersey enrollment
Medicare enrollment name: Inspira Health Network Medical Group PC
258 clinicians in this Medicare group

NPI 1922177856 (856) 507-2783

Inspira Sj Urgent Care PC

29 mi

Urgent Care

3722 E LANDIS AVE, SUITE 1
Vineland, NJ 08361

Reassigned Medicare billing, New Jersey enrollment
40 clinicians in this Medicare group

NPI 1619320991 (856) 213-5871

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

Areas of Expertise CMS Part B claims 14

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

373 services226 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

110 services110 patients

Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preve G0513

Prolonged preventive service refers to an extended medical consultation or treatment beyond the usual time. This service, provided in an outpatient setting, involves direct patient contact for the first 30 minutes beyond the primary procedure. It's used when additional time is required to address preventive health needs.

40 services40 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

30 services30 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza 87428

This test uses a method called immunoassay to identify severe acute respiratory syndrome coronavirus and influenza. It works by detecting specific proteins (antigens) in a sample, like a nasal swab. It's a powerful tool in diagnosing these viral infections.

24 services23 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

24 services24 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.

20 services19 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

20 services20 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

18 services17 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

17 services17 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

16 services16 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

15 services15 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

14 services14 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

11 services11 patients

Hospital Affiliations CMS Care Compare

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

Inspira Medical Center Mullica Hill

Acute Care Hospitals · Mullica Hill, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310069

Location700 Mullica Hill RdMullica Hill, NJ 08062 · Gloucester County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08085 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

$94.90 typical visit price

range $61.59 – $185.05

Typical copayment $23.72 (range $15.39 – $46.26)

Most-billed visit code 99203

Established Patient

$107.94 typical visit price

range $20.08 – $150.98

Typical copayment $26.98 (range $5.02 – $37.74)

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.

Other Providers at the Same Location NPPES

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

KEARA LEIGH EAGAN APN

Nurse Practitioner (Gerontology)

40 VILLAGE GREEN DR STE B
SWEDESBORO, NJ 08085

Gloucester County (856) 467-7360

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 Sean Sussman's NPI number?

The NPI number for Sean Sussman is 1316468895. It was assigned to this individual provider in the NPPES registry on July 5, 2017.

Where is Sean Sussman located?

Sean Sussman practices at 40 Village Green Dr Ste B, Swedesboro, NJ 08085. The listed phone number is (856) 467-7360.

What is Sean Sussman's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Sean Sussman enrolled in Medicare?

Yes. Sean Sussman 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.

Which organizations bill Medicare for Sean Sussman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sean Sussman reassigns Medicare benefits to 3 organizations: Inspira Health Network Urgent Care, P.C. (Mullica Hill, NJ), Inspira Health Network Medical Group, P.C. (Glassboro, NJ) and Inspira Sj Urgent Care PC (Vineland, NJ). 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 Sean Sussman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sean Sussman accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Oscar Health list Sean Sussman as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Sean Sussman affiliated with any hospitals?

According to CMS data, Sean Sussman is affiliated with Inspira Medical Center Mullica Hill.

When was this NPI record last updated?

The NPPES record for Sean Sussman was last updated on May 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.