Active NPI
Michael Suchoski
- Orthotist
- Portland, OR
National Provider Identifier
1043766231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotist
- License
- ABC02970
- Practice address
- 3101 SW Sam Jackson Park Rd
Portland, OR 97239-3009 - Phone
- (503) 221-3430
- NPI assigned
- Aug 29, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotist | 222Z00000X | ABC02970 | OR | Primary |
| Prosthetist | 224P00000X | ABC02970 | OR |
Addresses
Primary practice location
3101 SW Sam Jackson Park Rd
Portland, OR 97239-3009
Mailing address
PO Box 865109
Orlando, FL 32886-5109
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ABC02970 | OR | MD | Orthotist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472428800000",
"number": "1043766231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 865109",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328865109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3101 SW SAM JACKSON PARK RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972393009",
"telephone_number": "503-221-3430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUCHOSKI",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-29",
"last_updated": "2016-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "222Z00000X",
"taxonomy_group": "",
"desc": "Orthotist",
"state": "OR",
"license": "ABC02970",
"primary": true
},
{
"code": "224P00000X",
"taxonomy_group": "",
"desc": "Prosthetist",
"state": "OR",
"license": "ABC02970",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.