Individual provider Active NPI

Suzanne Marshall, PA-C

  • Medical Physician Assistant
  • Houston, TX
National Provider Identifier
1053696468
Registry record updated Dec 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA05294 Issued in TX
Practice address
12755 Woodforest Blvd
Houston, TX 77015-2737
Phone
(713) 455-1306
Fax
(713) 455-9560
NPI assigned
Oct 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA05294 TX Primary

Addresses

Primary practice location

12755 Woodforest Blvd
Houston, TX 77015-2737

Mailing address

5941 Dallas Pkwy
Ste 100
Plano, TX 75093-9002
Phone (972) 758-4455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120112000132 TX Practitioner - Physician Assistant 0749457927 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Doctors of Internal Medicine PAGroup PAC ID 5092750620, 27 clinicians

Practice addresses (Care Compare)

240 Adriatic Pkwy
McKinney, TX 75070-8278
Phone (972) 382-9292

5941 Dallas Pkwy
Suite 100
Plano, TX 75093-9002
Phone (972) 758-4455

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA05294TXMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: suzanne.marshall@doim.eclinicaldirectplus.com

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575504000000",
    "number": "1053696468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5941 DALLAS PKWY",
            "address_2": "STE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750939002",
            "telephone_number": "972-758-4455",
            "fax_number": "972-758-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12755 WOODFOREST BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770152737",
            "telephone_number": "713-455-1306",
            "fax_number": "713-455-9560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-17",
        "last_updated": "2019-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA05294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.