NPIMap

Organization Active NPI

Summit Family Medicine - LLC

Doing business as Summit Family Medicine

  • Family Medicine Physician
  • Hood River, OR
National Provider Identifier
1811157902
Registry record updated May 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SUMMIT FAMILY MEDICINE - LLC
Doing business as
Summit Family Medicine
Practice address
1021 June St
Hood River, OR 97031-1516
Phone
(541) 386-2204
Fax
(541) 386-6566
NPI assigned
Jun 11, 2008
Last updated
May 1, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2012

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

Authorized official

Name
Marisa Marquez
Title
Office Specialist
Phone
(541) 386-2204

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1021 June St
Hood River, OR 97031-1516

Mailing address

1021 June St
Hood River, OR 97031-1516
Phone (541) 386-2204

Other identifiers 1

IdentifierTypeStateIssuer
R144865OtherPTAN

Other names 1

  • Summit Family Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090102000441 OR Part B Supplier - Clinic/Group Practice 2961564703 Receives reassigned benefits from 13 practitioners
Practice locations: Hood River, OR

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D1093382Summit Family Medicine LLC1021 June Street, Hood River, OR 97031Provider-performed microscopyDec 16, 2026

National Provider Directory

National Provider Directory

Locations

1021 June St
Hood River, OR 97031
Phone (541) 386-0007

1021 June St
Ste 101
Hood River, OR 97031

1021 June St
Ste 102
Hood River, OR 97031
Phone (541) 386-3883

1021 June St
Ste 103
Hood River, OR 97031
Phone (541) 386-0007

1021 June St
Ste 104
Hood River, OR 97031
Phone (541) 386-3626

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335830400000",
    "number": "1811157902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 JUNE ST",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970311516",
            "telephone_number": "541-386-2204",
            "fax_number": "541-386-6566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 JUNE ST",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970311516",
            "telephone_number": "541-386-2204",
            "fax_number": "541-386-6566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT FAMILY MEDICINE - LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-11",
        "last_updated": "2012-05-01",
        "status": "A",
        "authorized_official_last_name": "MARQUEZ",
        "authorized_official_first_name": "MARISA",
        "authorized_official_title_or_position": "OFFICE SPECIALIST",
        "authorized_official_telephone_number": "541-386-2204"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "R144865",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hood River, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.