Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kenneth Roger Susman, MD

Individual provider Specialist · NPI 1962551119

Kenneth Roger Susman, MD is a General Surgery in Fort Bragg, California. Graduated from University of California, Davis School of Medicine in 1988, 38 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in California.

Years since qualifying
38
Trained at
University of California, Davis School of Medicine
Licensed in
CA
In the registry since
2007
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

510 Cypress St Ste B
Fort Bragg, CA 95437-5411
Phone: (707) 961-1972
Fax: (707) 961-1978
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence G679520 (CA)

Record details

NPI number1962551119
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJanuary 9, 2007
Last updated in NPPESJuly 8, 2007
Mailing address510 Cypress St, Suite B, Fort Bragg, CA 95437-5411

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolUNIVERSITY OF CALIFORNIA, DAVIS SCHOOL OF MEDICINE
Graduated 1988 (38 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Fort Bragg