Individual provider Active NPI

Suzanne Ellen Enloe-Whitaker, DO

  • Rheumatology Physician
  • San Bernardino, CA
National Provider Identifier
1720058415
Registry record updated Nov 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
20A7535 Issued in CA
Practice address
1700 North Waterman Ave
San Bernardino, CA 92404-5105
Phone
(909) 883-8611
Fax
(909) 886-1798
NPI assigned
Jan 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 20A7535 CA Primary

Addresses

Primary practice location

1700 North Waterman Ave
San Bernardino, CA 92404-5105

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 579-3203

Other identifiers 1

IdentifierTypeStateIssuer
00AX75350MedicaidCA

Other names 1

  • Dr. Suzanne Ellen Enloe Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20050803000512 CA Practitioner - RheumatologyPractitioner - Internal Medicine 2062440662 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Chicago College of Osteopathy, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Beaver Medical Group P CGroup PAC ID 0547164295, 251 clinicians

Practice addresses (Care Compare)

1700 N Waterman Ave
San Bernardino, CA 92404-5115
Phone (909) 883-8611

2 W Fern Ave
Redlands, CA 92373-5916
Phone (909) 793-3311

Hospital & facility affiliations

  • Mountains Community Hospital Hospital, Lake Arrowhead, CA, CCN 051312

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A7535CAMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beaver Medical Group P C Rheumatology CurrentSince Feb 1, 2023 Accepting new patients
Beaver Medical Group P C CurrentSince Feb 1, 2023 Accepting new patients
Redlands Family Practice Medical Group Inc. CurrentSince Sep 1, 2019 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 1, 2024 Accepting new patients
Redlands Family Physicians Medical Associates, Inc. Current Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 1, 2024 Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

17051 Sierra Lakes Pkwy
Ste 103
Fontana, CA 92336
Phone (909) 770-1000

1520 Barton Rd
Redlands, CA 92373
Phone (909) 793-3208

2 W Fern Ave
Redlands, CA 92373
Phone (909) 335-4137

2 W Fern Ave
#1112
Redlands, CA 92373

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

Interoperability endpoints

  • Direct secure messaging: senloewhiaker22093@epiclp.direct-ci.com

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763251200000",
    "number": "1720058415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-579-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 NORTH WATERMAN AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924045105",
            "telephone_number": "909-883-8611",
            "fax_number": "909-886-1798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENLOE-WHITAKER",
        "first_name": "SUZANNE",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2025-11-16",
        "certification_date": "2025-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CA",
            "license": "20A7535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX75350",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUZANNE",
            "last_name": "ENLOE",
            "middle_name": "ELLEN",
            "prefix": "DR.",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.