Individual provider Active NPI

Bjoern Dominik Suckow, M.D.

  • Vascular Surgery Physician
  • Lebanon, NH
National Provider Identifier
1861644791
Registry record updated Aug 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
17537 Issued in NH
Practice address
1 Medical Center Dr
Dartmouth Hitchcock - Vascular Surgery
Lebanon, NH 03756-1000
Phone
(603) 650-8677
NPI assigned
Oct 22, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 7152073-1205 UT
Vascular Surgery Physician 2086S0129X 17537 NH Primary

Addresses

Primary practice location

1 Medical Center Dr
Dartmouth Hitchcock - Vascular Surgery
Lebanon, NH 03756-1000

Mailing address

1 Medical Center Dr
Dartmouth Hitchcock - Vascular Surgery
Lebanon, NH 03756-1000
Phone (603) 650-8677

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20160722000682 NH Practitioner - Vascular SurgeryPractitioner - General Surgery 5597997627 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dartmouth-Hitchcock ClinicGroup PAC ID 4183537509, 1,445 clinicians
Mary Hitchcock Memorial HospitalGroup PAC ID 4486561164, 1,269 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17537NHMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Hitchcock Memorial Hospital CurrentSince Jul 1, 2016 Accepting new patients
Dartmouth-Hitchcock Clinic Surgery CurrentSince Jul 1, 2016 Accepting new patients
Catholic Medical Center CurrentSince Oct 29, 2024 Accepting new patients
Catholic Medical Center Vascular Surgery CurrentSince Oct 29, 2024 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jul 1, 2016 Accepting new patients

Locations

160 S River Rd
Ste 100
Bedford, NH 03110
Phone (603) 647-0494

253 Pleasant St
Concord, NH 03301
Phone (603) 226-2200

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2271

195 McGregor St
Ste 310
Manchester, NH 03102

87 McGregor St
Ste 3100
Manchester, NH 03102
Phone (603) 627-1887

100 Hitchcock Way
Manchester, NH 03104
Phone (603) 629-1870

2300 Southwood Dr
Nashua, NH 03063
Phone (603) 577-4170

Interoperability endpoints

  • Direct secure messaging: bsuckow148893@direct.dartmouth-hitchcock.org

Organizations & group practices 5

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": "1224633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471219200000",
    "number": "1861644791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "DARTMOUTH HITCHCOCK - VASCULAR SURGERY",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-8677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "DARTMOUTH HITCHCOCK - VASCULAR SURGERY",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-8677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUCKOW",
        "first_name": "BJOERN",
        "middle_name": "DOMINIK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-22",
        "last_updated": "2016-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "UT",
            "license": "7152073-1205",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NH",
            "license": "17537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.