Wendy Sue Suckow, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9101731 Issued in FL

Practice address

8380 Riverwalk Park Blvd Ste 100
Fort Myers, FL 33919

Phone

(239) 343-9960

Fax

(239) 343-9977

NPI assigned

Mar 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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

Merit-based Incentive Payment System (MIPS)

Final score

94.65 of 100Reported as group

Quality

90.03

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Cape Coral Emergency Physicians LLC

  • Emergency Medicine Physician
  • Cape Coral, FL
  • NPI 1376611962
  Medicare reassignment
• Cardiothoracic & Vascular Surgical Associates PA

  • Vascular & Interventional Radiology Physician
  • Jacksonville, FL
  • NPI 1851403125
  Medicare reassignment
• Emergency Medicine Services of FL, LLC

  • Emergency Medicine Physician
  • Aventura, FL
  • NPI 1043917180
  Medicare reassignment
• Southwest Florida Emergency Physicians, PA

  • Emergency Medicine Physician
  • Fort Myers, FL
  • NPI 1588659502
  Medicare reassignment
• Tampa Bay Emergency Physicians-Heartland LLC

  • Emergency Medicine Physician
  • Sebring, FL
  • NPI 1043661408
  Medicare reassignment

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

{
    "created_epoch": "1142035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1205804515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-9960",
            "fax_number": "239-343-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8380 RIVERWALK PARK BLVD STE 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33919",
            "telephone_number": "239-343-9960",
            "fax_number": "239-343-9977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5460 Blanding Blvd",
            "address_2": "UFJP Anchor Plaza Family Practice Center",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322441957",
            "country_code": "US",
            "telephone_number": "904-777-4730",
            "fax_number": "904-777-1241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUCKOW",
        "first_name": "WENDY",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-11",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9101731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102496300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100002372A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paula Anita Subadan, LCSW
• Daren Dianan Subnaik, D.O.
• Patricia Carolina Subnaik, D.O.
• Successful Steps Support Care LLC
• Natalya Suchodolski, MD
• David B Sudderth, M.D.
• Aiste Sudmantaite
• Avinash Rai Sukhram, M.D
• Allison Sullivan, M.A., M.F.T.
• Clarissa Sullivan

• Physician Assistant in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.