Individual provider Active NPI

Suzanne M Ponsioen, LMFT

  • Marriage & Family Therapist
  • Eugene, OR
National Provider Identifier
1831309293
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
T0783 Issued in OR
Practice address
328 W Broadway
Eugene, OR 97401-2826
Phone
(541) 653-2958
Fax
(541) 610-1760
NPI assigned
May 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X T0783 OR Primary

Addresses

Primary practice location

328 W Broadway
Eugene, OR 97401-2826

Mailing address

328 W Broadway
Eugene, OR 97401-2826
Phone (541) 653-2958

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
I20240226003578 OR Practitioner - Marriage and Family Therapist 0749625010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

328 W Broadway
Eugene, OR 97401-2826
Phone (541) 653-2958

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T0783ORMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Suzanne Ponsioen Therapy LLC Marriage & Family Therapist CurrentSince Jan 10, 2024 Accepting new patients

Organizations & group practices 1

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1831309293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 W BROADWAY",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012826",
            "telephone_number": "541-653-2958",
            "fax_number": "541-610-1760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 W BROADWAY",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012826",
            "telephone_number": "541-653-2958",
            "fax_number": "541-610-1760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONSIOEN",
        "first_name": "SUZANNE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T0783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.