Individual provider Active NPI

Keiko Suzuki, MD

  • Family Medicine Physician
  • Johnson City, TN
National Provider Identifier
1437389376
Registry record updated Feb 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
48755 Issued in TN
Practice address
401 E Main St
Johnson City, TN 37601-4877
Phone
(423) 929-2584
Fax
(423) 722-2060
NPI assigned
Jul 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2015

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 48755 TN Primary

Addresses

Primary practice location

401 E Main St
Johnson City, TN 37601-4877

Mailing address

1500 W Elk Ave
Elizabethton, TN 37643-2654
Phone (423) 929-2584

Other identifiers 1

IdentifierTypeStateIssuer
48755OtherTNLICENSE

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20121008000405 TN Practitioner - Family Practice 2163671157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
East Tennessee State University Quillen College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Care PLLCGroup PAC ID 1850448580, 40 clinicians
Champion Physical Therapy LLC HallsGroup PAC ID 1355416306, shared by 4 NPIs, 277 clinicians

Practice addresses (Care Compare)

1500 W Elk Ave
Elizabethton, TN 37643-3776
Phone (423) 543-2584

420 Railroad St
Elizabethton, TN 37643-2504
Phone (423) 297-1813

Hospital & facility affiliations

  • Amedisys Home Health Care Home health agency, Elizabethton, TN, CCN 447505
  • Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063

Merit-based Incentive Payment System (MIPS)

Final score
88.39 of 100Reported as group
Quality
86.98
Promoting interoperability
92
Improvement activities
40
Cost
80.98

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Care PLLC Family Medicine CurrentSince Feb 1, 2015 Accepting new patients
Inpatient Consultants of Tennessee, P.C. Past Accepting new patients

Locations

401 E Main St
Johnson City, TN 37601
Phone (423) 722-2062

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.

Hospital & facility affiliations 4

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": "1248393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423699200000",
    "number": "1437389376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 W ELK AVE",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376432654",
            "telephone_number": "423-929-2584",
            "fax_number": "423-722-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E MAIN ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376014877",
            "telephone_number": "423-929-2584",
            "fax_number": "423-722-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUZUKI",
        "first_name": "KEIKO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-24",
        "last_updated": "2015-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "48755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "48755",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.