NPIMap

Individual provider Active NPI

Emma Suzuki Murugaverl

  • Family Medicine Physician
  • Albany, OR
National Provider Identifier
1255994083
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
PG194050 Issued in OR
Practice address
1700 Geary St SE Ste 200
Albany, OR 97322-6842
Phone
(541) 812-5570
NPI assigned
Apr 17, 2019
Last updated
Sep 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X PG194050 OR Primary

Addresses

Primary practice location

1700 Geary St SE Ste 200
Albany, OR 97322-6842

Mailing address

PO Box 1188
Corvallis, OR 97339-1188

Other practice location 1

3600 NW Samaritan Dr
Corvallis, OR 97330-3737
Phone (541) 768-4906

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address emurugaverl166409@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241211001236 CO Practitioner - Family Practice 7416281282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Broomfield, CO 80021
Phone (720) 807-4461

8350 Colorado Blvd
Unit 160
Firestone, CO 80504-6803
Phone (303) 673-1370

8758 Wolff CT
200 Westminister Clinic
Westminster, CO 80031-6904
Phone (303) 403-6650

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC Family Medicine Current Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Oct 6, 2024 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Oct 6, 2024 Accepting new patients

Locations

500 Eldorado Blvd
Ste 4300
Broomfield, CO 80021

8758 Wolff Ct
Ste 200
Westminster, CO 80031
Phone (303) 403-6650

Interoperability endpoints

  • Direct secure messaging: emurugaverl166409@samhealth.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1255994083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1188",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 GEARY ST SE STE 200",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973226842",
            "telephone_number": "541-812-5570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 NW Samaritan Dr",
            "address_purpose": "LOCATION",
            "city": "Corvallis",
            "state": "OR",
            "postal_code": "973303737",
            "country_code": "US",
            "telephone_number": "541-768-4906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MURUGAVERL",
        "first_name": "EMMA",
        "middle_name": "SUZUKI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-17",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "PG194050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "emurugaverl166409@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "1700 Geary St SE Ste 200",
            "city": "Albany",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973226842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albany, OR

Sources for this page

Verify at the official NPI Registry.