Suzanne O Dater, MD
Individual provider Active NPI Internal Medicine Physician · Bridgton, ME
NPI 1225009830 · NPPES record last updated Feb 6, 2024
Key facts
- NPI
- 1225009830
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- MD15341 (ME)
- Practice address
- 101 Portland Rd
Bridgton, ME 04009-1256 - Phone
- (207) 255-7552
- Fax
- (207) 569-6150
- NPI assigned
- Jan 31, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.57 of 100
- Quality
- 66.56
- Promoting interoperability
- 99
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 1, 2023 through Oct 1, 2027
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD15341 | ME | MD | Internal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD15341 | ME | Yes |
Addresses
Primary practice location
101 Portland Rd
Bridgton, ME 04009-1256
Mailing address
101 Portland Rd
Bridgton, ME 04009-1256
Phone (207) 255-7552
Other providers in Bridgton, ME
- Jeremy Cass
- Kristen M Charest
- Ronald Cilley
- Julie Coffin
- Jennifer Cyr
- Scott Johnston Davis
- Cassandra Dee
- Dennis J Sullivan, M.D., P.a.
- Donald Earl Dennison
- R. Andrew Derstine
All providers in Bridgton, ME · Internal Medicine Physician in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.