Daniel L Sudakin, MD, MPH

Primary specialty

Medical Toxicology (Preventive Medicine) PhysicianTaxonomy code 2083T0002X

License

MD19994 Issued in OR

Practice address

9370 SW Greenburg Rd
Suite 201
Portland, OR 97223

Phone

(503) 894-9258

Fax

(888) 307-3066

NPI assigned

Jul 30, 2006

Last updated

Oct 20, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 5, 2016 through May 5, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508457600000",
    "number": "1255346029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9370 SW GREENBURG RD",
            "address_2": "SUITE 201",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97223",
            "telephone_number": "503-894-9258",
            "fax_number": "888-307-3066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9370 SW GREENBURG RD",
            "address_2": "SUITE 201",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97223",
            "telephone_number": "503-894-9258",
            "fax_number": "888-307-3066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8083 SE 13th Ave",
            "address_2": "Suite 3",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972026668",
            "country_code": "US",
            "telephone_number": "971-533-5840",
            "fax_number": "888-307-3066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUDAKIN",
        "first_name": "DANIEL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2017-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083T0002X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Medical Toxicology",
            "state": "OR",
            "license": "MD19994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Subtle Bodywork, LLC
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• Michael Suchoski
• Christopher George Suciu
• Holly Marie Suda, M.S.CCC-SLP
• Samantha Sudano
• Charles John Sudbeck, MS
• Christopher Lee Sudduth, M.D.
• Roksolana Sudyk, MD
• Sue-Chin Liu, DMD, PHD, PC (Bethany Orthodontics)

• Medical Toxicology (Preventive Medicine) Physician in Portland, OR
• Providers in Portland, OR by specialty
• Medical Toxicology (Preventive Medicine) Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2017; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.