Susan Yvonne Michelle Eiteljorge, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP144091 Issued in TX

Practice address

125 Northshore Blvd
Portland, TX 78374-4206

Phone

(361) 852-6824

NPI assigned

Jun 28, 2020

Last updated

Jun 28, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Group practices

Rabagos Health Care PLLCGroup PAC ID 5991926032, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Rabagos Health Care PLLC

  dba Statcare Minor Emergency Clinic

  • Family Medicine Physician
  • Kingsville, TX
  • NPI 1689924904
  Medicare reassignment Care Compare group NPD
• Calallen Minor Emergency Center, PA

  • General Practice Physician
  • Corpus Christi, TX
  • NPI 1861547234
  Medicare reassignment NPD
• CC Doctors Center Portland, PLLC

  dba The Doctors Center Urgent Care

  • General Practice Physician
  • Portland, TX
  • NPI 1821544396
  Medicare reassignment NPD
• Nueces Emergency Services, PA

  dba The Doctors Center

  • General Practice Physician
  • Corpus Christi, TX
  • NPI 1346395928
  Medicare reassignment NPD
• QC Professional PLLC

  • Family Medicine Physician
  • Corpus Christi, TX
  • NPI 1598352700
  NPD (past)

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

{
    "created_epoch": "1593302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593302400000",
    "number": "1528685385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 ANGEL OAK",
            "city": "ROCKPORT",
            "state": "TX",
            "postal_code": "783824429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 NORTHSHORE BLVD",
            "city": "PORTLAND",
            "state": "TX",
            "postal_code": "783744206",
            "telephone_number": "361-852-6824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EITELJORGE",
        "first_name": "SUSAN",
        "middle_name": "YVONNE MICHELLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-28",
        "last_updated": "2020-06-28",
        "certification_date": "2020-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP144091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blanca Estella Deleon, SLP
• Jorge Dominguez Jr.
• Marka Jane Dredla
• James A Duncan, DDS
• Avegiyel Ellis Dunn, DO
• Maria Lorena Ellison
• Encompass Counseling, PLLC
• Enjoy Speech, LLC
• Desarae Escamilla
• Andrew L Esquivel, R.PH.

• Family Nurse Practitioner in Portland, TX
• Providers in Portland, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.