Jason Ray Surratt, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

DP00330 Issued in OR

Practice address

9900 SW Hall Blvd
Suite 100
Tigard, OR 97223

Phone

(503) 245-2420

Fax

(503) 245-2445

NPI assigned

Aug 22, 2006

Sex

Male

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 OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

California School of Podiatric Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Extremity Specialists LLCGroup PAC ID 3577881747, 21 clinicians

Clear Choice DermatologyGroup PAC ID 4789005034, 47 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jason.surratt@pfac.eclinicaldirectplus.com

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.

• Clear Choice Dermatology

  dba The Skin Docs

  • Dermatology Physician
  • The Dalles, OR
  • NPI 1891327185
  Medicare reassignment Care Compare group NPD
• Northwest Extremity Specialists LLC

  • Podiatrist
  • Portland, OR
  • NPI 1295126241
  Medicare reassignment Care Compare group NPD
• Northwest Extremity Specialists LLC

  dba NES Wilsonville

  • Podiatric Clinic/Center
  • Wilsonville, OR
  • NPI 1346973039
  NPD

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1649386541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 SW HALL BLVD",
            "address_2": "SUITE 100",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "97223",
            "telephone_number": "503-245-2420",
            "fax_number": "503-245-2445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 SW HALL BLVD",
            "address_2": "SUITE 100",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "97223",
            "telephone_number": "503-245-2420",
            "fax_number": "503-245-2445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURRATT",
        "first_name": "JASON",
        "middle_name": "RAY",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OR",
            "license": "DP00330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "228891",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Supplemental Health Care
• Supplemental Healthcare
• Daniel Suppnick, D.C.
• Alexis Michelle Supry
• Wanida Surichamorn, RPH
• Samantha Suter
• Suzanne Lawton, LLC (Dr. Suzanne Lawton)
• Misako Suzuki, CCC-SLP
• Malaysia Swain
• Kathryn Reece Swanson

• Podiatrist in Tigard, OR
• Providers in Tigard, OR by specialty
• Podiatrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; 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.