Active NPI
Suzanne D. Peregoy, D.O.
- Family Medicine Physician
- Medical Lake, WA
National Provider Identifier
1043657729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- OP60630409
- Practice address
- 850 Maple Street
Medical Lake, WA 99022-0800 - Phone
- (509) 565-4000
- Fax
- (509) 565-4705
- NPI assigned
- Jun 4, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | OP60630409 | WA | Primary |
Addresses
Primary practice location
850 Maple Street
Medical Lake, WA 99022-0800
Mailing address
P.O. Box 800
Medical Lake, WA 99022-0800
Phone (509) 565-4066
Other names 1
- Suzanne D. Bemis
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OP60630409 | WA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Department of Social Dept of SHS Div of Instns | Current | Accepting new patients | |
| Eastern State Hospital Pharmacy | Past | Accepting new patients | |
| Department of Social | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Eastern State Hospital
- Psychiatric Hospital
- Medical Lake, WA
- NPI 1467440602
-
- Long Term Care Pharmacy
- Medical Lake, WA
- NPI 1679651970
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695686400000",
"number": "1043657729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 800",
"city": "MEDICAL LAKE",
"state": "WA",
"postal_code": "990220800",
"telephone_number": "509-565-4066",
"fax_number": "509-565-4705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 MAPLE STREET",
"city": "MEDICAL LAKE",
"state": "WA",
"postal_code": "990220800",
"telephone_number": "509-565-4000",
"fax_number": "509-565-4705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREGOY",
"first_name": "SUZANNE",
"middle_name": "D.",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-06-04",
"last_updated": "2023-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "OP60630409",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SUZANNE",
"last_name": "BEMIS",
"middle_name": "D.",
"credential": "D.O.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Medical Lake, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.