Theresa M Sutak, MSN, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP.020536 Issued in OH

Practice address

1425 N Fairfield Rd Ste 130
Beavercreek, OH 45432-2673

Phone

(937) 320-1950

Fax

(937) 320-9332

NPI assigned

Jul 11, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Little Clinic of Ohio LLCGroup PAC ID 7719087584, 212 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

86.78 of 100Reported as group

Quality

71.59

Promoting interoperability

100

Improvement activities

40

Cost

84.34

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: theresa.sutak@krogerhealth.eclinicaldirectplus.com

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.

• The Little Clinic of Ohio LLC

  • Family Nurse Practitioner
  • Cincinnati, OH
  • NPI 1982761896
  Medicare reassignment Care Compare group NPD
• Pediatric Associates of Dayton, Inc.

  • Pediatrics Physician
  • Beavercreek, OH
  • NPI 1174792584
  NPD (past)
• Premier Integrated Medical Assoc LTD

  dba PriMed Physicians

  • Family Medicine Physician
  • Kettering, OH
  • NPI 1285690339
  NPD (past)

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1881046167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 NORTH MAIN STREET",
            "address_2": "SUITE 332",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "45415",
            "telephone_number": "937-832-7337",
            "fax_number": "937-832-4817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 N FAIRFIELD RD STE 130",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454322673",
            "telephone_number": "937-320-1950",
            "fax_number": "937-320-9332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTAK",
        "first_name": "THERESA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-11",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3010369",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.020536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack Joseph Sudekum
• Dennis Michael Sullivan, M.D.
• Kelly Glen Sullivan
• Stephanie M Sullivan, DPT
• Stephanie Lynn Summerlin
• Holly A Sutton
• Antonela Svetic, MD
• Charles Swafford II, APRN-CNP
• Jordan Swain, MS, LPCC
• Tamu Swanson, FNP-C

• Family Nurse Practitioner in Beavercreek, OH
• Providers in Beavercreek, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.