Susie Li Tan, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Garfield Heights, Ohio. Her current practice location is
12300 Mccracken Rd, Garfield Heights, Ohio. You can reach out to her office (for appointments etc.) via phone at
(216) 581-0500.
Susie Li Tan is licensed to practice in Ohio (license number 0021057) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1841030491.
Provider's Profile
| Full Name | Susie Li Tan |
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| Gender | Female |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 12300 Mccracken Rd, Garfield Heights, Ohio |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1841030491
- Provider Enumeration Date: 05/30/2024
- Last Update Date: 05/30/2024
Medicare PECOS Information:
- PECOS PAC ID: 1456899020
- Enrollment ID: I20240814000283
Medical Identifiers
Medical identifiers for Susie Li Tan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1841030491 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 367500000X | Nurse Anesthetist, Certified Registered | 0021057 (Ohio) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Susie Li Tan allows following entities to bill medicare on her behalf.
| Entity Name | The Cleveland Clinic Foundation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1679525919
PECOS PAC ID: 1850203555
Enrollment ID: O20031103000049 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Susie Li Tan is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Susie Li Tan,
5000 Acacia Ct,
Independence, OH 44131-4618
Ph: (646) 315-1756 | Susie Li Tan,
12300 Mccracken Rd,
Garfield Heights, OH 44125-2914
Ph: (216) 581-0500 |
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