Individual provider Active NPI

Susan St. Onge, FNP

  • Family Nurse Practitioner
  • Portland, TX
National Provider Identifier
1609930023
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
598821 Issued in TX
Practice address
107 Cedar Dr
Portland, TX 78374-2935
Phone
(361) 643-6623
Fax
(361) 643-6964
NPI assigned
Dec 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 598821 TX Primary

Addresses

Primary practice location

107 Cedar Dr
Portland, TX 78374-2935

Mailing address

107 Cedar Dr
Portland, TX 78374-2935
Phone (361) 643-6623

Other identifiers 1

IdentifierTypeStateIssuer
165240601MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address susan.st.onge.1@29601.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040702001075 TX Practitioner - Nurse Practitioner 7810974243 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
598821TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centerwell Senior Primary Care (SC) PC CurrentSince May 28, 2024 Accepting new patients
Conviva Medical Center Management of Texas, P.a. CurrentSince May 28, 2024 Accepting new patients

Locations

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

260 US Highway 181 N
Floresville, TX 78114
Phone (830) 393-8222

107 Cedar Dr
Portland, TX 78374
Phone (361) 643-6623

Interoperability endpoints

  • Direct secure messaging: sstonge34934@direct.kelsey-seybold.com
  • Direct secure messaging: susan.st.onge.1@29601.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1609930023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 CEDAR DR",
            "city": "PORTLAND",
            "state": "TX",
            "postal_code": "783742935",
            "telephone_number": "361-643-6623",
            "fax_number": "361-643-6964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 CEDAR DR",
            "city": "PORTLAND",
            "state": "TX",
            "postal_code": "783742935",
            "telephone_number": "361-643-6623",
            "fax_number": "361-643-6964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. ONGE",
        "first_name": "SUSAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "598821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165240601",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "susan.st.onge.1@29601.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "107 Cedar Dr",
            "city": "Portland",
            "state": "TX",
            "country_code": "US",
            "postal_code": "783742935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, TX

Sources for this page

Verify at the official NPI Registry.