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

Susan Lyn Koelliker, MD

Individual provider Diagnostic Radiology Physician · NPI 1841288719

Susan Lyn Koelliker, MD is a Diagnostic Radiology in Providence, Rhode Island. Graduated from University of Cincinnati College of Medicine in 1991, 35 years ago. Practices with Rhode Island Medical Imaging Inc, a 107-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Massachusetts and Rhode Island.

Years since qualifying
35
Trained at
University of Cincinnati College of Medicine
Licensed in
MA, RI
In the registry since
2005
Specialties on file
2
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

593 Eddy St
Providence, RI 02903-4923
Phone: (401) 444-5174
Fax: (401) 921-9212
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 211 Park St, Attleboro, MA 02703-3143 — (508) 222-5200

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence MD08865 (RI)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 154179 (MA)

Record details

NPI number1841288719
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 13, 2005
Last updated in NPPESMarch 15, 2024
Certification dateMarch 15, 2024

Medicare enrollment

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

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolUNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE
Graduated 1991 (35 years in practice)
Group practice Rhode Island Medical Imaging Inc — 107 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations12 on file with Medicare

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