DR. SUSAN A. RUDDERS (NPI# 1528227303) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528227303 |
| Entity Type | Individual |
| Full Name | DR. SUSAN A. RUDDERS |
| Credential | M.D. |
| Practice Address |
300 Longwood Ave Boston MA 02115-5724 |
| Practice Telephone | 6173556117 |
| Practice Fax Number | 6177300310 |
| Mailing Telephone | 6173556117 |
| Mailing Fax Number | 6177300310 |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2016-11-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0201X |
Pediatrics Specialization: Pediatric Allergy/Immunology |
268858 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | LICENSE | 268858 | 01 |
| RI | LICENSE | MD13418 | 01 |
| Street Address |
300 LONGWOOD AVE |
| City | BOSTON |
| State | MA |
| Zip Code | 02115-5724 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588667539 | Barry Grant Zallen | Pediatrics | 300 Longwood Ave, Children's Hospital, Au 105, Boston, MA 02115-5724 | 2005-05-23 |
| 1730780669 | Hannah Fraser | Registered Nurse | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-11-06 |
| 1164023776 | Hannah Brewer | Social Worker | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-11-02 |
| 1104423680 | Justin Matthias Hintze | Otolaryngology | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-10-07 |
| 1295340388 | Kathryn Theresa Moffa | Psychologist | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-15 |
| 1144835224 | Abby Elizabeth Bandi | Social Worker | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-15 |
| 1558976845 | Hilary Segar Garber | Nurse Practitioner | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-13 |
| 1063026003 | Lauren M Dilullo | Psychologist | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-08 |
| 1013521004 | Carl Britto | Student in an Organized Health Care Education/Training Program | 300 Longwood Ave, Boston, MA 02115-5737 | 2020-09-07 |
| 1760096887 | Rebecca Marie Leslie | Nurse Practitioner | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524339 | Jacqueline Busa | Student in an Organized Health Care Education/Training Program | Northeastern University 336 Huntington Ave, Boston, MA 02115 | 2020-09-30 |
| 1417564279 | Katherine Rose Brainard | Student in an Organized Health Care Education/Training Program | 336 Huntington Avenue, Boston, MA 02115 | 2020-09-25 |
| 1679189112 | Tara Baxter | Orthopaedic Surgery | Boston Children's Hospital - Sports Medicine Division, 319 Longwood Avenue, Boston, MA 02115 | 2020-09-21 |
| 1053923110 | Wendy Tu | Student in an Organized Health Care Education/Training Program | 75 Francis Street Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115 | 2020-08-20 |
| 1477177335 | Nicolas Wyvekens | Student in an Organized Health Care Education/Training Program | 75 Francis Street Department of Pathology, Brigham And, Boston, MA 02115 | 2020-06-05 |
| 1669095923 | Erin Crocker | Student in an Organized Health Care Education/Training Program | Northeastern University Physician Assistant Program, 360 Huntington Avenue, Boston, MA 02115 | 2020-05-21 |
| 1033732417 | Tyler Francis Hayes | Student in an Organized Health Care Education/Training Program | Gordon Hall, Suite 213, 25 Shattuck Street, Boston, MA 02115 | 2020-05-20 |
| 1982225090 | Emily Blake | Student in an Organized Health Care Education/Training Program | 202 Robinson Hall, 360 Huntington Avenue, Boston, MA 02115 | 2020-04-29 |
| 1891315495 | Stephanie Schoch | Student in an Organized Health Care Education/Training Program | 360 Huntington Ave., 202 Robinson Hall, Boston, MA 02115 | 2020-04-23 |
| 1427678093 | Meghan Miles | Student in an Organized Health Care Education/Training Program | 360 Huntington Avenue 202 Robinson Hall, Boston, MA 02115 | 2020-04-23 |
| Find all providers in zip 02115 | ||||
| Taxonomy Code | 2080P0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Allergy/Immunology |
| A pediatrician who specializes in the diagnosis and treatment of allergies, allergic reactions, and immunologic diseases in children. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: title modified, definition added, source added] Additional Resources: A Certification of Special Qualifications (CSQ) is issued by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841533569 | Chen E Rosenberg | Pediatrics | 55 Fruit St, Boston, MA 02114-2696 | 2013-04-01 |
| 1972894988 | Brittany Elizabeth Esty | Pediatrics | 300 Longwood Ave, Boston, MA 02115 | 2011-04-25 |
| 1093984064 | Luigi Notarangelo | Pediatrics | 300 Longwood Ave, Fegan 6, Boston, MA 02115-5724 | 2008-02-25 |
| 1346330446 | Ana D Broyles | Pediatrics | 300 Longwood Ave, Boston, MA 02115-5724 | 2006-10-13 |
| 1104916204 | Dale T Umetsu | Pediatrics | 300 Longwood Ave, Boston, MA 02115-5724 | 2006-10-13 |
| 1427148535 | Robert P Sundel | Pediatrics | 300 Longwood Ave, Boston, MA 02115-5724 | 2006-10-13 |
| 1184651036 | Zameneh Mikhak | Pediatrics | 300 Longwood Ave, Boston, MA 02115-5724 | 2006-06-27 |
| 1922099563 | Elizabeth C Tepas | Pediatrics | 15 Parkman St, Wac 707, Boston, MA 02114-3117 | 2005-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083684955 | Thomas F Plaut | Pediatrics | 125 Red Gate Ln, Amherst, MA 01002-1844 | 2006-01-24 |
| 1376177790 | Greater Boston Allergy Asthma Sinus & Immunology Centers, P.C. | Pediatrics | 244 Willow St, Yarmouth Port, MA 02675-1757 | 2020-02-25 |
| 1568488161 | Michele J. Gottlieb | Pediatrics | 24 Newton St, Southborough, MA 01772-1215 | 2006-07-15 |
| 1821072547 | John L Sullivan | Pediatrics | 55 Lake Ave N, Department of Pediatric Allergy & Immunology, Worcester, MA 01655-0002 | 2005-12-06 |
| 1437153376 | Nathan Alan Harris | Pediatrics | 100 Mlk Jr Blvd, 2nd Floor, Worcester, MA 01608-1209 | 2005-06-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.