Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Susie Martha Ivanov, PA-C

Individual provider Physician Assistant · NPI 1750769253

Mrs. Susie Martha Ivanov, PA-C is a Physician Assistant in Cincinnati, Ohio. Practices as a sole proprietor. Licensed in Ohio.

Licensed in
OH
In the registry since
2015
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

427 Oregon St Apt 7
Cincinnati, OH 45202-1634
Phone: (513) 807-5707
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 50.004262 (OH)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 50.004262 (OH)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 50.004262 (OH)

Record details

NPI number1750769253
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedMay 15, 2015
Last updated in NPPESMay 16, 2015

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