Individual provider Active NPI

Andrew Gary Suchocki, MD, MPH

  • Family Medicine Physician
  • Oregon City, OR
National Provider Identifier
1780804401
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD165025 Issued in OR
Practice address
1425 Beavercreek Rd
Oregon City, OR 97045-4076
Phone
(503) 655-8471
Fax
(503) 723-4946
NPI assigned
Apr 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35092730 OH
Family Medicine Physician 207Q00000X 43003 KY
Family Medicine Physician 207Q00000X MD165025 OR Primary

Addresses

Primary practice location

1425 Beavercreek Rd
Oregon City, OR 97045-4076

Mailing address

2051 Kaen Rd Ste 367
Oregon City, OR 97045-4035
Phone (503) 742-5300

Other identifiers 2

IdentifierTypeStateIssuer
3068899MedicaidOH
35-092730OtherOHOHIO MEDICAL LICENSE

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140424002124 OR Practitioner - Family Practice 9032256979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio State University College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

110 Beavercreek Rd
Oregon City, OR 97045-4307
Phone (503) 655-8471

39740 Pleasant St
Sandy, OR 97055-6412
Phone (503) 655-8471

9775 SE Sunnyside Rd
Clackamas, OR 97015-5721
Phone (503) 655-8471

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
County of Clackamas Office of County Auditor CurrentSince Oct 15, 2013 Accepting new patients
Clackamas County Current Accepting new patients
Clackamas County Past Accepting new patients
CG Medical Associates Inc Family Medicine PastSince Dec 1, 2021 Accepting new patients

Locations

2051 Kaen Rd
Ste 367
Oregon City, OR 97045
Phone (503) 742-5300

110 Beavercreek Rd
Ste 100
Oregon City, OR 97045

110 Beavercreek Rd
Oregon City, OR 97045
Phone (503) 655-8470

Interoperability endpoints

  • Direct secure messaging: asuchocki121271@direct.ochin.org

Organizations & group practices 4

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 3

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": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1780804401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 KAEN RD STE 367",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970454035",
            "telephone_number": "503-742-5300",
            "fax_number": "503-742-5979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 BEAVERCREEK RD",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970454076",
            "telephone_number": "503-655-8471",
            "fax_number": "503-723-4946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUCHOCKI",
        "first_name": "ANDREW",
        "middle_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35092730",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "43003",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD165025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3068899",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO MEDICAL LICENSE",
            "identifier": "35-092730",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon City, OR

Sources for this page

Verify at the official NPI Registry.