Active NPI
Susan I Vangorder, CRNA
- Certified Registered Nurse Anesthetist
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- Practice address
- 3181 SW Sam Jackson Park Road
Ohsu
Portland, OR 97239-3098 - Phone
- (503) 494-8014
- Fax
- (503) 494-2251
- NPI assigned
- Jul 19, 2005
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 0001131932 | VA | |
| Anesthesiology Physician | 207L00000X | 0024165997 | VA | |
| Certified Registered Nurse Anesthetist | 367500000X | OR | Primary |
Addresses
Primary practice location
3181 SW Sam Jackson Park Road
Ohsu
Portland, OR 97239-3098
Mailing address
3181 SW Sam Jackson Park Road
Ohsu
Portland, OR 97239-3098
Phone (503) 494-8014
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-7641
3181 Swsam Jackson Park Rd
Portland, OR 97239-3011
3303 S Bond Ave
Portland, OR 97239-4501
Phone (503) 494-7641
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 98.65
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0001131932 | VA | MD | Anesthesiology Physician |
| 0024165997 | VA | MD | Anesthesiology Physician |
| 200660019CRNA | OR | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Anesthesiology Associates, LLC | Anesthesiology | Current | Accepting new patients |
| Anesthesia Associates Northwest LLC | Anesthesiology | Current | Accepting new patients |
| Anesthesia Associates LTD. | Anesthesiology | Past | Accepting new patients |
Locations
3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674
120 NW 14th Ave
Ste 200
Portland, OR 97209
Phone (503) 771-1883
Interoperability endpoints
- svangordercrna21961@direct.ohsu.edu
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 and National Provider Directory roles.
-
- Anesthesiology Physician
- Portland, OR
- NPI 1841217817
-
- Anesthesiology Physician
- Milwaukie, OR
- NPI 1548281751
-
- Anesthesiology Physician
- Alexandria, VA
- NPI 1316947971
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Portland, OR
- NPI 1609824010
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190160000000",
"number": "1487653796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3181 SW SAM JACKSON PARK ROAD",
"address_2": "OHSU",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972393098",
"telephone_number": "503-494-8014",
"fax_number": "503-494-2251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3181 SW SAM JACKSON PARK ROAD",
"address_2": "OHSU",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972393098",
"telephone_number": "503-494-8014",
"fax_number": "503-494-2251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANGORDER",
"first_name": "SUSAN",
"middle_name": "I",
"name_prefix": "Ms.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-19",
"last_updated": "2007-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "VA",
"license": "0001131932",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "VA",
"license": "0024165997",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "OR",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.