Active NPI
Susan Paulena Corzilius, MD
- Family Medicine Physician
- Salem, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD29252
- Practice address
- 5125 Skyline Rd S
Kaiser Skyline Medical Office - Family Medicine
Salem, OR 97306-9427 - Phone
- (503) 361-5400
- NPI assigned
- Nov 13, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G81829 | CA | |
| Family Medicine Physician | 207Q00000X | DR.0069187 | CO | |
| Family Medicine Physician | 207Q00000X | MD29252 | OR | Primary |
Addresses
Primary practice location
5125 Skyline Rd S
Kaiser Skyline Medical Office - Family Medicine
Salem, OR 97306-9427
Mailing address
5125 Skyline Rd S
Kaiser Skyline Medical Office - Family Medicine
Salem, OR 97306-9427
Other practice location 1
10350 E Dakota Ave
Denver, CO 80247-1314
Phone (303) 338-4545
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) | |
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR, WA, CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G81829 | CA | MD | Family Medicine Physician |
| DR.0069187 | CO | MD | Family Medicine Physician |
| MD29252 | OR | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of Washington | Family Medicine | Current | Accepting new patients |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Colorado Permanente Medical Group, P.C. | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Northwest | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Northwest | Family Medicine | Current | Accepting new patients |
| Kaiser Foundation Health Plan of the Northwest | Family Medicine | Current | Accepting new patients |
Locations
10350 E Dakota Ave
Ofc
Denver, CO 80247
Phone (303) 344-7771
10350 E Dakota Ave
Denver, CO 80247
Phone (303) 636-3350
10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946
7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051
13705 NE Airport Way
Portland, OR 97230
Phone (503) 258-6800
2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400
5125 Skyline Rd S
Ofc
Salem, OR 97306
Phone (503) 361-5400
665 Winter St SE
Salem, OR 97301
Phone (503) 370-5634
1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801
200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530
9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800
7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000
Interoperability endpoints
- scorzilius2943406@ghc.direct-ci.net
Organizations & group practices 7
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.
-
- General Practice Physician
- Portland, OR
- NPI 1184786527
Family Medicine, WA
-
- Internal Medicine Physician
- Denver, CO
- NPI 1760599724
-
- Multi-Specialty Clinic/Center
- Seattle, WA
- NPI 1396810701
-
- General Practice Physician
- Portland, OR
- NPI 1306192455
Family Medicine
-
- Clinic/Center
- Hillsboro, OR
- NPI 1942718622
-
- Multi-Specialty Clinic/Center
- Renton, WA
- NPI 1124264577
Family Medicine
-
- Multi-Specialty Clinic/Center
- Everett, WA
- NPI 1386935351
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697068800000",
"number": "1205907268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5125 SKYLINE RD S",
"address_2": "KAISER SKYLINE MEDICAL OFFICE - FAMILY MEDICINE",
"city": "SALEM",
"state": "OR",
"postal_code": "973069427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5125 SKYLINE RD S",
"address_2": "KAISER SKYLINE MEDICAL OFFICE - FAMILY MEDICINE",
"city": "SALEM",
"state": "OR",
"postal_code": "973069427",
"telephone_number": "503-361-5400"
}
],
"practiceLocations": [
{
"address_1": "10350 E Dakota Ave",
"address_purpose": "LOCATION",
"city": "Denver",
"state": "CO",
"postal_code": "802471314",
"country_code": "US",
"telephone_number": "303-338-4545",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CORZILIUS",
"first_name": "SUSAN",
"middle_name": "PAULENA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-13",
"last_updated": "2023-10-12",
"certification_date": "2023-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "G81829",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CO",
"license": "DR.0069187",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD29252",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "5125 Skyline Rd S",
"address_2": "Kaiser Skyline Medical Office - Family Medicine",
"city": "Salem",
"state": "OR",
"country_code": "US",
"postal_code": "973069427",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "10350 E Dakota Ave",
"city": "Denver",
"state": "CO",
"country_code": "US",
"postal_code": "802471314",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.