Individual provider Active NPI

Suzanne Elice Dotson, PA-C

  • Physician Assistant
  • Portland, OR
National Provider Identifier
1225551609
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA184444 Issued in OR
Practice address
7240 NE Sandy Blvd
Portland, OR 97213-5741
Phone
(503) 477-6700
Fax
(971) 279-4771
NPI assigned
Jul 18, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 PA184444 OR Primary

Addresses

Primary practice location

7240 NE Sandy Blvd
Portland, OR 97213-5741

Mailing address

7240 NE Sandy Blvd
Portland, OR 97213-5741
Phone (503) 477-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20180322000349 OR Practitioner - Physician Assistant 3072875509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peacehealth Networks on Demand LLCGroup PAC ID 1759731383, 197 clinicians

Practice addresses (Care Compare)

10221 SE Sunnyside Rd
Clackamas, OR 97015-9782
Phone (864) 664-3984

17155 SE Sunnyside Rd
Suite 160
Happy Valley, OR 97015-8736
Phone (503) 684-8252

172 NE Martin Luther King Jr Blvd
Portland, OR 97232-2943
Phone (864) 664-3984

3060 SE Hawthorne Blvd
Portland, OR 97214-4121
Phone (864) 664-3984

4415 SE Woodstock Blvd
Portland, OR 97206-6271
Phone (864) 664-3984

606 NE Broadway St
Portland, OR 97232-1212
Phone (864) 664-3984

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Zoomcare PC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/30646/brand/1/csg/1/fhir/r4
  • Direct secure messaging: suzanne.dotson.1@30646.direct.athenahealth.com

Organizations & group practices 2

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": "1500336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1225551609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7240 NE SANDY BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972135741",
            "telephone_number": "503-477-6700",
            "fax_number": "971-279-4771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7240 NE SANDY BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972135741",
            "telephone_number": "503-477-6700",
            "fax_number": "971-279-4771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOTSON",
        "first_name": "SUZANNE",
        "middle_name": "ELICE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA184444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.