Susan A Doberneck, M.D.

Primary specialty

Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X

License

7169 Issued in NV

Practice address

1600 Medical Pkwy
Carson City, NV 89703-4625

Phone

(775) 445-8502

Fax

(775) 888-4448

NPI assigned

Nov 9, 2006

Last updated

Nov 23, 2009By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV

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

Specialty

Pathology

Education

University of New Mexico School of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Diagnostic Pathology Medical Group IncGroup PAC ID 2860489218, 32 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carson Tahoe Regional Medical Center Hospital, Carson City, NV, CCN 290019
• Carson Valley Health Hospital, Gardnerville, NV, CCN 291306

Merit-based Incentive Payment System (MIPS)

Final score

84.18 of 100Reported as group

Quality

80.24

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Diagnostic Pathology Medical Group, Inc.

  • Anatomic Pathology & Clinical Pathology Physician
  • Carson City, NV
  • NPI 1417636093
  Medicare reassignment Care Compare group NPD
• Diagnostic Pathology Medical Group Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Reno, NV
  • NPI 1770064271
  NPD
• Diagnostic Pathology Medical Group Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Sacramento, CA
  • NPI 1235138868
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Carson Tahoe Regional Healthcare

  • General Acute Care Hospital
  • Carson City, NV
  • NPI 1255360160
  Care Compare affiliation
• Carson Tahoe Regional Healthcare

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Carson City, NV
  • NPI 1568281988

  Hospital

  Care Compare affiliation
• Washoe Barton Medical Clinic a Nevada Nonprofit Corporation

  dba CVMC Outpatient Behavioral Health Clinic

  • Community/Behavioral Health Agency
  • Gardnerville, NV
  • NPI 1104482918

  Hospital

  Care Compare affiliation
• Washoe Barton Medical Clinic a Nevada Nonprofit Corporation

  dba Carson Valley Health

  • Critical Access Hospital
  • Gardnerville, NV
  • NPI 1396799102
  Care Compare affiliation

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258934400000",
    "number": "1639249022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21609",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897211609",
            "telephone_number": "775-884-2455",
            "fax_number": "775-884-0345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL PKWY",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897034625",
            "telephone_number": "775-445-8502",
            "fax_number": "775-888-4448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBERNECK",
        "first_name": "SUSAN",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2009-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "NV",
            "license": "7169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639249022",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marla Dietz
• Lisa Dill
• Nicholas J Dirig, DO
• Division of Health Care Financing and Policy
• Ashley Djukic, LCSW
• Meaghan M Dobson, PRSS-INT
• Andrew Doering, MD
• Gladys Pascual Dolor, APRN
• Adrianna Domaratuis
• Donald Campbell (Donald Campbell Psychology)

• Clinical Pathology/Laboratory Medicine Physician in Carson City, NV
• Providers in Carson City, NV by specialty
• Clinical Pathology/Laboratory Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2009; 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.