Individual provider Active NPI

Suzanne Pilegaard, CERTIFIED MASTECTOMY

  • Orthotic Fitter
  • Santa Rosa, CA
National Provider Identifier
1659602423
Registry record updated Jul 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthotic FitterTaxonomy code 225000000X
Practice address
101 Wikup Drive
Suite C
Santa Rosa, CA 95403-1375
Phone
(707) 526-0356
Fax
(707) 526-0376
NPI assigned
Jan 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthotic Fitter 225000000X Primary

Addresses

Primary practice location

101 Wikup Drive
Suite C
Santa Rosa, CA 95403-1375

Mailing address

101 Wikup Drive
Suite C
Santa Rosa, CA 95403-1375
Phone (707) 526-0356

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Saffron'S Specialized Medical, LLC Past Accepting new patients

Organizations & group practices 1

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": "1263859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310083200000",
    "number": "1659602423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 WIKUP DRIVE",
            "address_2": "SUITE C",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031375",
            "telephone_number": "707-526-0356",
            "fax_number": "707-526-0376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WIKUP DRIVE",
            "address_2": "SUITE C",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031375",
            "telephone_number": "707-526-0356",
            "fax_number": "707-526-0376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PILEGAARD",
        "first_name": "SUZANNE",
        "credential": "CERTIFIED MASTECTOMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-19",
        "last_updated": "2011-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225000000X",
            "taxonomy_group": "",
            "desc": "Orthotic Fitter",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.