Individual provider Active NPI

Suzanne A Hoekstra, M.D.

  • Surgery Physician
  • Portland, ME
National Provider Identifier
1508840216
Registry record updated Jul 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
018518 Issued in ME
Practice address
195 Fore River Pkwy
Suite 250
Portland, ME 04102-2780
Phone
(207) 553-6800
Fax
(207) 553-6810
NPI assigned
Dec 6, 2005
Last updated
Jul 6, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 9800276 NC
Surgery Physician 208600000X 018518 ME Primary

Addresses

Primary practice location

195 Fore River Pkwy
Suite 250
Portland, ME 04102-2780

Mailing address

195 Fore River Pkwy
Suite 250
Portland, ME 04102-2780
Phone (207) 553-6800

Other identifiers 2

IdentifierTypeStateIssuer
891146UMedicaidNC
1146UOtherNCBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20100903000206 ME Practitioner - General Surgery 1052200508

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.67 of 100Reported as group
Quality
60.7
Promoting interoperability
91
Improvement activities
40
Cost
73.8

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9800276NCMDSpecialist
018518MEMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Past Accepting new patients
Brevard Surgical Associates,PA Specialist PastSince Nov 1, 2003 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278374400000",
    "number": "1508840216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 FORE RIVER PKWY",
            "address_2": "SUITE 250",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022780",
            "telephone_number": "207-553-6800",
            "fax_number": "207-553-6810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 FORE RIVER PKWY",
            "address_2": "SUITE 250",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022780",
            "telephone_number": "207-553-6800",
            "fax_number": "207-553-6810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOEKSTRA",
        "first_name": "SUZANNE",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2010-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "9800276",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ME",
            "license": "018518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891146U",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1146U",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.