NPIMap

Individual provider Active NPI

Brianna Lynn Sustersic, M.D.

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1942468939
Registry record updated Dec 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD153915 Issued in OR
Practice address
727 W Burnside St
Portland, OR 97209-3514
Phone
(503) 228-4533
NPI assigned
May 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD153915 OR Primary

Addresses

Primary practice location

727 W Burnside St
Portland, OR 97209-3514

Mailing address

3814 N Longview Ave
Portland, OR 97227-1024
Phone (302) 893-2131

Other names 1

  • Brianna Lynn Cook Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110901000737 OR Practitioner - Internal Medicine 4688844509 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tuality Medical Group LLCGroup PAC ID 7416173414, 289 clinicians

Practice addresses (Care Compare)

335 SE 8TH Ave
Hillsboro, OR 97123-4246
Phone (503) 681-1111

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services Current Accepting new patients
Tuality Healthcare Current Accepting new patients
Tuality Medical Group LLC Internal Medicine CurrentSince Jul 21, 2021 Accepting new patients
Tuality Medical Group LLC CurrentSince Jul 21, 2021 Accepting new patients
University Professional Services CurrentSince Sep 1, 2011 Accepting new patients
University Professional Services CurrentSince Sep 1, 2011 Accepting new patients
Central City Concern Past Accepting new patients
Central City Concern, Inc Past Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

364 SE 8th Ave
Ste 301
Hillsboro, OR 97123
Phone (503) 681-4233

6355 NE Cornell Rd
Ste 100
Hillsboro, OR 97124
Phone (503) 597-3130

335 SE 8th Ave
Hillsboro, OR 97123
Phone (503) 681-1111

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

Interoperability endpoints

  • Direct secure messaging: bsustersicmd20816@direct.ohsu.edu

Organizations & group practices 8

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 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356480000000",
    "number": "1942468939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3814 N LONGVIEW AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271024",
            "telephone_number": "302-893-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 W BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093514",
            "telephone_number": "503-228-4533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSTERSIC",
        "first_name": "BRIANNA",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-28",
        "last_updated": "2012-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD153915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIANNA",
            "last_name": "COOK",
            "middle_name": "LYNN",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.