Active NPI
Phillip J Suffridge, M.D.
- Ophthalmology Physician
- Benton, AR
National Provider Identifier
1730142530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- E2274
- Practice address
- 3 Medical Park Dr
Suite 300
Benton, AR 72015-3728 - Phone
- (501) 778-1113
- Fax
- (501) 778-5391
- NPI assigned
- Apr 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | E2274 | AR | Primary |
Addresses
Primary practice location
3 Medical Park Dr
Suite 300
Benton, AR 72015-3728
Mailing address
3 Medical Park Dr Ste 300
Benton, AR 72015-3726
Phone (501) 778-1113
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 161592001 | Medicaid | AR | |
| 06040018300 | Other | AR | QUALCHOICE |
| 5N525 | Other | AR | BLUE CROSS BLUE SHIELD |
| P00445226 | Other | AR | RAILROAD MEDICARE |
| 204462170 | Other | AR | UNITED HEALTHCARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Ophthalmology
- Education
- University of Arkansas College of Medicine, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3 Medical Park Dr
Benton, AR 72015-3728
Phone (501) 778-1113
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 879 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E2274 | AR | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ophthalmology Associates of Benton, PLLC | Ophthalmology | Current | Accepting new patients |
| Phillip Suffridge,M.D.,P.a. | Ophthalmology | Past | Accepting new patients |
Locations
3 Medical Park Dr
Benton, AR 72015
Phone (501) 778-1113
3 Medical Park Dr
Ste 300
Benton, AR 72015
Phone (501) 778-1113
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.
-
- Ophthalmology Physician
- Benton, AR
- NPI 1376684258
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Primary Care Clinic/Center
- Plainview, AR
- NPI 1871852434
Hospital
-
- Primary Care Clinic/Center
- Danville, AR
- NPI 1073748406
Hospital
-
- Primary Care Clinic/Center
- Havana, AR
- NPI 1346431384
Hospital
-
- Rural Acute Care Hospital
- Danville, AR
- NPI 1902842255
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380499200000",
"number": "1730142530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 MEDICAL PARK DR STE 300",
"city": "BENTON",
"state": "AR",
"postal_code": "720153726",
"telephone_number": "501-778-1113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 MEDICAL PARK DR",
"address_2": "SUITE 300",
"city": "BENTON",
"state": "AR",
"postal_code": "720153728",
"telephone_number": "501-778-1113",
"fax_number": "501-778-5391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUFFRIDGE",
"first_name": "PHILLIP",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-11",
"last_updated": "2013-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "AR",
"license": "E2274",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "161592001",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "QUALCHOICE",
"identifier": "06040018300",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "5N525",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00445226",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "204462170",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Benton, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2013; 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.