Individual provider Active NPI

Suzanne M Richardson, PA C

  • Medical Physician Assistant
  • Puyallup, WA
National Provider Identifier
1417068263
Registry record updated May 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA10004546 Issued in WA
Practice address
11216 Sunrise Blvd E Ste 3-102
Puyallup, WA 98374-8848
Phone
(253) 848-3000
Fax
(253) 845-8750
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA10004546 WA Primary

Addresses

Primary practice location

11216 Sunrise Blvd E Ste 3-102
Puyallup, WA 98374-8848

Mailing address

1703 S Meridian Ste 101
Puyallup, WA 98371-7590
Phone (253) 848-3000

Other identifiers 1

IdentifierTypeStateIssuer
8372955MedicaidWA

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040507001108 WA Practitioner - Physician Assistant 6901700103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cascade Eye and Skin Centers PCGroup PAC ID 4486541554, 47 clinicians

Practice addresses (Care Compare)

11216 Sunrise Blvd E
Suite 3 106
Puyallup, WA 98374-8848
Phone (253) 848-3000

4907 Point Fosdick Dr NW
Suite E700
Gig Harbor, WA 98335-1842
Phone (253) 848-3000

5225 Cirque Dr W
University Place, WA 98467-3638
Phone (253) 564-3365

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cascade Eye & Skin Centers P.C. CurrentSince Jun 1, 2008 Accepting new patients

Locations

205 10th St NE
Ste 119
Auburn, WA 98002
Phone (253) 939-7911

10004 204th Ave E
Ste 1500
Bonney Lake, WA 98391

4907 Point Fosdick Dr
Ste E700
Gig Harbor, WA 98335

11216 Sunrise Blvd E
Ste 3-102
Puyallup, WA 98374

11216 Sunrise Blvd E
Ste 3
Puyallup, WA 98374
Phone (253) 445-2385

1703 S Meridian
Ste 101
Puyallup, WA 98371
Phone (253) 770-7708

11216 Sunrise Blvd E
Ste 3102
Puyallup, WA 98374

5225 Cirque Dr W
Ste 200
University Place, WA 98467
Phone (253) 564-3365

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525651200000",
    "number": "1417068263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 S MERIDIAN STE 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983717590",
            "telephone_number": "253-848-3000",
            "fax_number": "253-845-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11216 SUNRISE BLVD E STE 3-102",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983748848",
            "telephone_number": "253-848-3000",
            "fax_number": "253-845-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "SUZANNE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2018-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10004546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8372955",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.