Individual provider Active NPI

Suzette Reine Wisdom, PA-C

  • Medical Physician Assistant
  • Yuma, AZ
National Provider Identifier
1093299075
Registry record updated Jul 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
7203 Issued in AZ
Practice address
2775 S 8TH Ave
Yuma, AZ 85364-7110
Phone
(928) 341-0700
NPI assigned
Sep 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110006948 VA
Physician Assistant 363A00000X 333188 LA
Medical Physician Assistant 363AM0700X 7203 AZ Primary

Addresses

Primary practice location

2775 S 8TH Ave
Yuma, AZ 85364-7110

Mailing address

2775 S 8TH Ave
Yuma, AZ 85364-7110
Phone (928) 341-0700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, LA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190218000144 AZ Practitioner - Physician Assistant 3779821723 Reassigns benefits to 1 organization
I20220929003917 LA Practitioner - Physician Assistant 3779821723 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Up2Par PLLCGroup PAC ID 7416955745, 14 clinicians

Practice addresses (Care Compare)

11463 S Foothills Blvd
Yuma, AZ 85367-5701
Phone (928) 955-0189

2775 S 8TH Ave
Yuma, AZ 85364-7110
Phone (928) 341-0700

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, Yuma, AZ, CCN 037280
  • Unicare Healthcare, Inc Home health agency, Yuma, AZ, CCN 037808
  • Caring Touch Home Care, LLC Home health agency, Yuma, AZ, CCN 037298
  • Yuma Regional Medical Center Hospital, Yuma, AZ, CCN 030013

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110006948VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors After Hours LLC CurrentSince Sep 1, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: suzettewisdom@apc.allscriptsdirect.net
  • FHIR API: https://fhir4.healow.com/fhir/r4/AEJBAA/Endpoint/AEJBAA

Organizations & group practices 4

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 4

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": "1537142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752364800000",
    "number": "1093299075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2775 S 8TH AVE",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853647110",
            "telephone_number": "928-341-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2775 S 8TH AVE",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853647110",
            "telephone_number": "928-341-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISDOM",
        "first_name": "SUZETTE",
        "middle_name": "REINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-17",
        "last_updated": "2025-07-13",
        "certification_date": "2025-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110006948",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "333188",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "7203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

Verify at the official NPI Registry.