Individual provider Active NPI

Gina Suzanne Sucato, MD

  • Pediatric Adolescent Medicine Physician
  • Bellevue, WA
National Provider Identifier
1861468720
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
MD00036277 Issued in WA
Practice address
13451 SE 36TH St
Bellevue, WA 98006-1475
Phone
(425) 562-1337
Fax
(425) 562-1331
NPI assigned
Feb 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X MD00036277 WA Primary

Addresses

Primary practice location

13451 SE 36TH St
Bellevue, WA 98006-1475

Mailing address

13451 SE 36TH St
Bellevue, WA 98006-1475
Phone (425) 562-1350

Other practice location 1

3420 5th Ave
Room 147
Pittsburgh, PA 15213-3205
Phone (412) 692-6677

Other identifiers 1

IdentifierTypeStateIssuer
001846189MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20151125001872 WA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 2961487897

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00036277WAMDPediatric Adolescent Medicine Physician

Interoperability endpoints

  • Direct secure messaging: gsucato146843@ghc.direct-ci.net

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1861468720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13451 SE 36TH ST",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980061475",
            "telephone_number": "425-562-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13451 SE 36TH ST",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980061475",
            "telephone_number": "425-562-1337",
            "fax_number": "425-562-1331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3420 5th Ave",
            "address_2": "Room 147",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152133205",
            "country_code": "US",
            "telephone_number": "412-692-6677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUCATO",
        "first_name": "GINA",
        "middle_name": "SUZANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "WA",
            "license": "MD00036277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001846189",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "13451 SE 36th St",
            "city": "Bellevue",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980061475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.