Individual provider Active NPI

Ildiko Suto, PSY.D.

  • Clinical Psychologist
  • Hillsboro, OR
National Provider Identifier
1760799480
Registry record updated Oct 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2045 Issued in OR
Practice address
21210 NW Mauzey Rd
Hillsboro, OR 97124-9327
Phone
(503) 439-9531
Fax
(503) 531-3841
NPI assigned
Sep 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2045 OR Primary

Addresses

Primary practice location

21210 NW Mauzey Rd
Hillsboro, OR 97124-9327

Mailing address

PO Box 82819
Portland, OR 97282-0819
Phone (503) 233-5405

Other identifiers 1

IdentifierTypeStateIssuer
164936MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111214001024 OR Practitioner - Clinical Psychologist 4789859042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Western Psychological and Counseling Services LLCGroup PAC ID 7719975085, 331 clinicians

Practice addresses (Care Compare)

21210 NW Mauzey Rd
Hillsboro, OR 97124-9327
Phone (503) 439-9531

8280 NE Mauzey CT
Hillsboro, OR 97124-9092
Phone (503) 439-9531

880 82ND Dr
Gladstone, OR 97027-1803
Phone (503) 659-5515

890 82ND Dr
Gladstone, OR 97027-1803
Phone (503) 659-5515

890 SE
82ND
Gladstone, OR 97027-1803
Phone (503) 659-5515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Western Psychological and Counseling Services LLC Clinical CurrentSince Nov 1, 2011 Accepting new patients
Western Psychological and Counseling Services LLC Clinical CurrentSince Nov 1, 2011 Accepting new patients
Western Psychological and Counseling Services PC Past Accepting new patients

Locations

880 82nd Dr
Gladstone, OR 97027
Phone (503) 626-9494

10151 SE Sunnyside Rd
Ste 480
Happy Valley, OR 97015
Phone (503) 739-8321

8280 NE Mauzey Ct
Hillsboro, OR 97124
Phone (503) 439-9531

21210 NW Mauzey Rd
Hillsboro, OR 97124
Phone (503) 439-9531

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.ildikosuto@148835.advancedmd-direct.com

Organizations & group practices 3

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": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317945600000",
    "number": "1760799480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82819",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972820819",
            "telephone_number": "503-233-5405",
            "fax_number": "503-531-3841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21210 NW MAUZEY RD",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971249327",
            "telephone_number": "503-439-9531",
            "fax_number": "503-531-3841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTO",
        "first_name": "ILDIKO",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-01",
        "last_updated": "2011-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "2045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164936",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

Verify at the official NPI Registry.