Individual provider Active NPI

Suzanne Michele Jagger, CRNA

  • Certified Registered Nurse Anesthetist
  • Portland, OR
National Provider Identifier
1174652473
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
201602463CRNA-PP Issued in OR
Practice address
12525 NW Cornell Rd Ste 204
Portland, OR 97229-5615
Phone
(971) 232-9232
NPI assigned
Mar 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 626041 CA
Certified Registered Nurse Anesthetist 367500000X 201602463CRNA-PP OR Primary

Addresses

Primary practice location

12525 NW Cornell Rd Ste 204
Portland, OR 97229-5615

Mailing address

1925 NW 126TH PL
Portland, OR 97229-4627
Phone (408) 364-6103

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070502000324 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4587760830 Reassigns benefits to 1 organization
I20130926000765 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 4587760830 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Complete Anesthesia Care LLCGroup PAC ID 7214187210, 17 clinicians

Practice addresses (Care Compare)

1130 NW 22ND Ave
Suite 615
Portland, OR 97210-2977
Phone (503) 229-7137

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
201602463CRNA-PPORMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest Nurse Anesthetist, Certified Registered CurrentSince Jul 29, 2013 Accepting new patients
Complete Anesthesia Care LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2015 Accepting new patients
Oregon Anesthesiology Group PC CurrentSince Apr 1, 2016 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jul 29, 2013 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Nurse Anesthetist, Certified Registered Current Accepting new patients
Anesthesia Associates Northwest LLC CurrentSince Nov 1, 2015 Accepting new patients
Metropolitan Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2015 Accepting new patients
M. Atchison Crna Inc, a Professional Nursing Corp. Nurse Anesthetist, Certified Registered CurrentSince Oct 9, 2019 Accepting new patients

Locations

1000 Trancas St
Napa, CA 94558
Phone (707) 226-2901

7500 Hospital Dr
Sacramento, CA 95823
Phone (916) 423-3000

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

1130 NW 22nd Ave
Ste 615
Portland, OR 97210
Phone (503) 229-7137

9701 SW Barnes Rd
Ste 300
Portland, OR 97225
Phone (503) 297-8081

120 NW 14th Ave
Ste 200
Portland, OR 97209
Phone (503) 771-1883

707 SW Washington St
Ste 700
Portland, OR 97205

1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582

1130 NW 22nd Ave
Ste 410
Portland, OR 97210
Phone (503) 229-7137

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1172966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1174652473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 NW 126TH PL",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972294627",
            "telephone_number": "408-364-6103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12525 NW CORNELL RD STE 204",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295615",
            "telephone_number": "971-232-9232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGGER",
        "first_name": "SUZANNE",
        "middle_name": "MICHELE",
        "name_prefix": "Dr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-04",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "626041",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OR",
            "license": "201602463CRNA-PP",
            "primary": true
        }
    ],
    "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 Jan 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.