Susan Oldenkamp, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD00023394 Issued in WA

Practice address

12811 8TH Ave W
Suite D-109
Everett, WA 98204-6335

Phone

(425) 743-7888

Fax

(425) 355-3055

NPI assigned

Feb 24, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

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.

Enrollment records 1

Specialty

Dermatology

Education

University of Washington School of Medicine, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Dermatology CoGroup PAC ID 1658546437, 5 clinicians

Spokane Dermatology Clinic PSGroup PAC ID 9931098357, 5 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: soldenkamp@kittitasvalleyhealthcare.cernerdirect.com

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.

• Family Dermatology Co

  • Dermatology Physician
  • Oak Harbor, WA
  • NPI 1275816910
  Medicare reassignment Care Compare group NPD
• Spokane Dermatology Clinic PS

  • Dermatology Physician
  • Spokane, WA
  • NPI 1649367889
  Medicare reassignment Care Compare group NPD
• Kittitas County Public Hospital Dist 1

  • Critical Access Hospital
  • Ellensburg, WA
  • NPI 1356375307
  Medicare reassignment NPD
• PNW Wound Specialist LLC

  • Medical Physician Assistant
  • Spokane Valley, WA
  • NPI 1497542229
  Medicare reassignment NPD
• Kittitas County Public Hosp Dist 1

  • Urology Physician
  • Ellensburg, WA
  • NPI 1437029832
  NPD
• Kittitas County Public Hospital Dist 1

  • Rural Health Clinic/Center
  • Ellensburg, WA
  • NPI 1932115391
  NPD

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

{
    "created_epoch": "1172275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275523200000",
    "number": "1275669459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12811 8TH AVE W",
            "address_2": "SUITE D-109",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982046335",
            "telephone_number": "425-743-7888",
            "fax_number": "425-355-3055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12811 8TH AVE W",
            "address_2": "SUITE D-109",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982046335",
            "telephone_number": "425-743-7888",
            "fax_number": "425-355-3055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDENKAMP",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-24",
        "last_updated": "2010-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD00023394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "91-1504734",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1011832",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael S Okelley, PT
• Yukinori Oki, MS. ATC. PES
• Bianca Mikael Okinda
• Briggett Lorraine Okocha, MHT III
• Lori Ann Olberding, MSW
• Alexandra Sergeevna Olgova, MA, LMHC
• Eileen M. Olinger, MD
• Isla Sage Oliver, CNM
• Michael James Oliver
• William Donald Oliver, DDS

• Dermatology Physician in Everett, WA
• Providers in Everett, WA by specialty
• Dermatology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.