Active NPI
Tara R Suntoke, PA-C, PHD, MPH
- Physician Assistant
- Lebanon, NH
National Provider Identifier
1467980979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1272
- Practice address
- 1 Medical Center Dr
Lebanon, NH 03756-1000 - Phone
- (603) 650-5261
- NPI assigned
- May 28, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1272 | NH | Primary |
Addresses
Primary practice location
1 Medical Center Dr
Lebanon, NH 03756-1000
Mailing address
One Medical Center Drive
Gi/Hepatology
Lebanon, NH 03756-0001
Phone (603) 650-5261
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1272 | NH | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1467980979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "ONE MEDICAL CENTER DRIVE",
"address_2": "GI/HEPATOLOGY",
"city": "LEBANON",
"state": "NH",
"postal_code": "037560001",
"telephone_number": "603-650-5261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEDICAL CENTER DR",
"city": "LEBANON",
"state": "NH",
"postal_code": "037561000",
"telephone_number": "603-650-5261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUNTOKE",
"first_name": "TARA",
"middle_name": "R",
"credential": "PA-C, PHD, MPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-28",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NH",
"license": "1272",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.