NPIMap

Individual provider Active NPI

Suzanne La Lande, PA-C

  • Physician Assistant
  • Bend, OR
National Provider Identifier
1114477833
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA190291 Issued in OR
Practice address
431 NE Revere Ave Ste 200
Bend, OR 97701-4192
Phone
(541) 508-7973
Fax
(541) 508-7968
NPI assigned
Oct 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA190291 OR Primary

Addresses

Primary practice location

431 NE Revere Ave Ste 200
Bend, OR 97701-4192

Mailing address

1698 E McAndrews Rd Ste 280
Medford, OR 97504-5590
Phone (541) 774-5808

Other practice location 1

1698 E McAndrews Rd Ste 280
Medford, OR 97504-5590
Phone (541) 774-5808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190102000753 OR Practitioner - Physician Assistant 8628313228 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Oregon Health Sciences University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cascade Lakes Urology LLCGroup PAC ID 4981128519, 3 clinicians

Practice addresses (Care Compare)

431 NE Revere Ave
Suite 200
Bend, OR 97701-4192
Phone (541) 508-7973

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.87 of 100Reported as individual
Quality
83.5
Improvement activities
40
Cost
74.92

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: suzanne.la.lande.1@32606.direct.athenahealth.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 7

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": "1475625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1114477833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1698 E MCANDREWS RD STE 280",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975045590",
            "telephone_number": "541-774-5808",
            "fax_number": "541-732-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 NE REVERE AVE STE 200",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014192",
            "telephone_number": "541-508-7973",
            "fax_number": "541-508-7968"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1698 E McAndrews Rd Ste 280",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975045590",
            "country_code": "US",
            "telephone_number": "541-774-5808",
            "fax_number": "541-732-3910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LA LANDE",
        "first_name": "SUZANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-05",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA190291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.