Alicia Suzanna Gimenez, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00033032 Issued in WA

Practice address

212 Skyline Dr
White Salmon, WA 98672

Phone

(509) 493-2133

Fax

(509) 493-9538

NPI assigned

Aug 22, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mrs. R. Allen Laberge Other name

Medicare fee-for-service enrollment

Enrolled in WA, OR2 enrollments

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 2

Specialty

Family Practice

Education

University of Washington School of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

One Community HealthGroup PAC ID 6305759283, shared by 7 NPIs, 51 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Skyline Hospital Hospital, White Salmon, WA, CCN 501315
• Providence Hood River Memorial Hospital Hospital, Hood River, OR, CCN 381318
• Mid-Columbia Medical Center Hospital, The Dalles, OR, CCN 380001

Merit-based Incentive Payment System (MIPS)

Final score

95 of 100Reported as group

Quality

83.34

Promoting interoperability

100

Improvement activities

40

Cost

100

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• One Community Health

  • Federally Qualified Health Center (FQHC)
  • White Salmon, WA
  • NPI 1376221259
  Medicare reassignment NPD
• One Community Health

  • Federally Qualified Health Center (FQHC)
  • Hood River, OR
  • NPI 1851385918
  Medicare reassignment NPD
• One Community Health

  • Community/Retail Pharmacy
  • The Dalles, OR
  • NPI 1104666064
  NPD

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

• Public Hospital District No. 2, Klickitat County, Washington

  • Critical Access Hospital
  • White Salmon, WA
  • NPI 1760455687
  Care Compare affiliation
• Mid-Columbia Medical Center

  • Critical Access Hospital Clinic/Center
  • The Dalles, OR
  • NPI 1306842752
  Care Compare affiliation
• Providence Health & Services Oregon

  • Critical Access Hospital
  • Hood River, OR
  • NPI 1255429338
  Care Compare affiliation

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314316800000",
    "number": "1780676148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1519",
            "city": "WHITE SALMON",
            "state": "WA",
            "postal_code": "986721519",
            "telephone_number": "509-493-2133",
            "fax_number": "509-493-9538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 SKYLINE DR",
            "city": "WHITE SALMON",
            "state": "WA",
            "postal_code": "98672",
            "telephone_number": "509-493-2133",
            "fax_number": "509-493-9538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIMENEZ",
        "first_name": "ALICIA",
        "middle_name": "SUZANNA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-22",
        "last_updated": "2011-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00033032",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD20959",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8194987",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "R.",
            "last_name": "LABERGE",
            "middle_name": "ALLEN",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Raymond John Fitzsimmons, MD
• Rachel Leigh Fleischut
• Robert E Franzen, MD
• Cassondra Fuller
• Justin Allen Gere, MSOM, L.AC
• Gorge Therapy Group PLLC
• Maggie Rose Goter, PA-C
• Paul Grim, MS
• Grove Institute PLLC
• Holly H Hamilton, DPT

• Family Medicine Physician in White Salmon, WA
• Providers in White Salmon, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.