KENNETH ROGER SUSMAN M.D.
NPI 1962551119
Specialist in Fort Bragg, CA

Active since January 09, 2007PECOS EnrolledAccepts Medicare Assignment
73.79/100
CMS Quality Rating
510 CYPRESS ST, SUITE B, FORT BRAGG, CA 95437(707) 961-1972(707) 961-1978 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kenneth Roger Susman M.d. NPPES

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

KENNETH ROGER SUSMAN M.D. (NPI 1962551119) is an individual specialist in Fort Bragg, California, licensed in California (G679520) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS and is a graduate of University Of California, Davis School Of Medicine (1988).

NPPES Registry Identity

NPI1962551119
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameKENNETH ROGER SUSMANCredential: M.D.
Location Address510 CYPRESS ST, SUITE BFort Bragg, CA 95437-5411
Mailing Address510 Cypress St, Suite BFort Bragg, CA 95437-5411 · (707) 961-1972 · Fax (707) 961-1978
Fax(707) 961-1978
Sole ProprietorYes
Medical School CMSUniversity Of California, Davis School Of MedicineGraduated 1988
Enumeration DateJanuary 9, 2007
Last NPPES UpdateJuly 8, 2007
NPI 1962551119 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License Licensed in CA · G679520
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.
510 CYPRESS ST, Fort Bragg, CA 95437

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

Kenneth Roger Susman 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 ID5890953756
PECOS Enrollment IDI20120223000091
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 12

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.

Destruction of precancer skin growth, 2-14 growths 17003
This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.
435 services50 patients
Destruction of precancer skin growth, 1 growth 17000
"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.
99 services59 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.
60 services60 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.
57 services42 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
49 services49 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.
47 services44 patients

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

73.79/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality76.87
Promoting Interoperability92
Improvement Activities40
Cost36.93

Other Providers at the Same Location NPPES 3

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

Registered Nurse (Lactation Consultant)
510 CYPRESS ST, STE D
FORT BRAGG, CA 95437
Optometrist
510 CYPRESS ST, STE A
FORT BRAGG, CA 95437
Acupuncturist
510 CYPRESS ST, SUITE C200
FORT BRAGG, CA 95437

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 Kenneth Susman's NPI number?

The NPI number for Kenneth Susman is 1962551119. It was assigned to this individual provider in the NPPES registry on January 9, 2007.

Where is Kenneth Susman located?

Kenneth Susman practices at 510 Cypress St Suite B, Fort Bragg, CA 95437. The listed phone number is (707) 961-1972.

What is Kenneth Susman's specialty?

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

Is Kenneth Susman enrolled in Medicare?

Yes. Kenneth Susman 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.

When was this NPI record last updated?

The NPPES record for Kenneth Susman was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.