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NORTHEASTERN RURAL HEALTH CLINICS
NPI 1477563518
Family Medicine in Susanville, CA

Active since August 09, 2006
1850 SPRING RIDGE DR, SUSANVILLE, CA 96130(530) 251-5000(530) 252-1340 Get Directions Write a Review

NPPES record last updated: September 10, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 10, 2025, Aug 21, 2024, Dec 28, 2020 and 2 more (5 updates tracked since 2016).

About Northeastern Rural Health Clinics NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NORTHEASTERN RURAL HEALTH CLINICS (NPI 1477563518) is a healthcare organization registered as a family medicine in Susanville, California and active in the NPI registry since August 2006. The organization lists Lacey L Lively, Ceo, as its authorized official.

NPPES Registry Identity

NPI1477563518
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameNORTHEASTERN RURAL HEALTH CLINICS
Location Address1850 SPRING RIDGE DRSusanville, CA 96130-6100
Mailing Address1850 Spring Ridge DrSusanville, CA 96130-6100 · (530) 251-5000 · Fax (530) 252-1340
Phone(530) 251-5000
Fax(530) 252-1340
Organization SubpartYesParent: Northeastern Health Center
Authorized OfficialLacey L LivelyCeo · (530) 251-5000
Enumeration DateAugust 9, 2006
Last NPPES UpdateSeptember 10, 20255 updates tracked since enumeration
NPPES CertifiedSeptember 10, 2025
✔ NPI 1477563518 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1850 SPRING RIDGE DR, Susanville, CA 96130
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Other Identifiers 6

Other080061921Rrmcr Morgan
MedicaidFHC70081FCA
Other080005169Rrmcr Dozier
Other080119610Rrmcr Davainis
Other080042465Rrmcr Holmes
OtherZZZ87615ZBlue Shield

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Northeastern Rural Health Clinics is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

19

Medicare enrollment records show 19 clinicians reassign Medicare billing to Northeastern Rural Health Clinics, which bills Medicare for the services they deliver. Of these, 6 practice at this address and 7 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 5

Nurse Practitioner10
Family Practice4
Obstetrics/Gynecology3
Mental Health Counselor1
Registered Dietitian or Nutrition Professional1

Clinicians, nearest first (19)

Donna Dinette, AGPCNP
Nurse Practitioner
NPI 1174330146
1850 SPRING RIDGE DR
Susanville, CA 96130
(530) 251-5000
✔ PECOS✔ Accepts MedicareSame address
Allen Varma, NP
Nurse Practitioner
NPI 1508703224
1850 SPRING RIDGE DR
Susanville, CA 96130
(530) 251-5000
✔ PECOS✔ Accepts MedicareSame address
Michele Wilson, APRN-CNP
Nurse Practitioner
NPI 1518647874
1850 SPRING RIDGE DR
Susanville, CA 96130
(530) 251-5000
✔ PECOS✔ Accepts MedicareSame address
Steven Braatz, MD
Obstetrics/Gynecology
NPI 1265403117
1850 SPRING RIDGE DR
Susanville, CA 96130
(530) 257-9677
✔ PECOS✔ Accepts MedicareSame address
Samuel Carlton, MD
Family Practice
NPI 1437156866
1850 SPRING RIDGE DR
Susanville, CA 96130
(530) 251-5000
✔ PECOS✔ Accepts MedicareSame address
Rachel Petersen, M.D.
Family Practice
NPI 1528353323
1850 SPRING RIDGE DR
Susanville, CA 96130
(530) 251-5000
✔ PECOS✔ Accepts MedicareSame address
Peggy Vaquera, LPCC
Mental Health Counselor
NPI 1609413756
1306 RIVERSIDE DR
Susanville, CA 96130
(530) 260-0344
✔ PECOS2.3 mi
Tanya Villers, APRN, FNP-C
Nurse Practitioner
NPI 1487153300
1111 N NAGLE ST
Alturas, CA 96101
(530) 708-8820
✔ PECOS✔ Accepts Medicare73 mi
Elsie Jimenez, APRN
Nurse Practitioner
NPI 1134826274
401 RYLAND ST STE 200A
Reno, NV 89502
(775) 535-6607
✔ PECOS✔ Accepts Medicare77 mi
Lisa Murphy, MD
Obstetrics/Gynecology
NPI 1174506315
200 W COOLIDGE AVE
Modesto, CA 95350
(209) 577-5005
✔ PECOS✔ Accepts Medicare192 mi
Kimberly Clinite, MD
Family Practice
NPI 1366837163
1175 MOUNT HOOD AVE
Woodburn, OR 97071
(503) 982-2000
✔ PECOS✔ Accepts Medicare344 mi
Nubia Daguia, F.N.P.
Nurse Practitioner
NPI 1336459387
2120 CIENAGA ST
Oceano, CA 93445
(805) 994-2100
✔ PECOS✔ Accepts Medicare368 mi
Ira Silverman, M.D.
Obstetrics/Gynecology
NPI 1316004005
3291 LOMA VISTA RD
Ventura, CA 93003
(805) 652-6556
✔ PECOS432 mi
Alexinna Johns, M.D.
Family Practice
NPI 1073731006
1322 3RD ST SE STE 240
Puyallup, WA 98372
(253) 697-5757
✔ PECOS✔ Accepts Medicare473 mi
Jacob Dowling, RD, LD, CDE
Registered Dietitian or Nutrition Professional
NPI 1700280518
2211 LOMAS BLVD NE
Albuquerque, NM 87106
(505) 272-6632
850 mi
Pamela Migliaccio, APRN, CNP
Nurse Practitioner
NPI 1689059610
17420 NE 23RD ST STE A
Choctaw, OK 73020
(405) 641-3644
✔ PECOS✔ Accepts Medicare1,318 mi
Mueni Mualuko, CNP
Nurse Practitioner
NPI 1083027536
2925 CHICAGO AVE
Minneapolis, MN 55407
(612) 863-4000
✔ PECOS✔ Accepts Medicare1,420 mi
Barbara Purvis, NP
Nurse Practitioner
NPI 1194169086
9821 LIMA RD
Fort Wayne, IN 46818
(260) 240-5027
✔ PECOS✔ Accepts Medicare1,847 mi
Caroline Bonfanti, PMHNP
Nurse Practitioner
NPI 1619308731
24 WINNIPEG LN
Lawrence, NJ 08648
(609) 334-8096
✔ PECOS✔ Accepts Medicare2,395 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Northeastern Rural Health Clinics's NPI number?

The NPI number for Northeastern Rural Health Clinics is 1477563518. It was assigned to this organization in the NPPES registry on August 9, 2006.

Where is Northeastern Rural Health Clinics located?

Northeastern Rural Health Clinics is located at 1850 Spring Ridge Dr, Susanville, CA 96130. The listed phone number is (530) 251-5000.

What is Northeastern Rural Health Clinics's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Northeastern Rural Health Clinics enrolled in Medicare?

Yes. Northeastern Rural Health Clinics is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Northeastern Rural Health Clinics?

According to the CMS Revalidation Reassignment List (October 2026 release), 19 clinicians in 5 Medicare specialties reassign their Medicare billing to Northeastern Rural Health Clinics. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (10), Family Practice (4) and Obstetrics/Gynecology (3). Of these, 6 practice at this address and 7 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Northeastern Rural Health Clinics accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and UnitedHealthcare list Northeastern Rural Health Clinics as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Northeastern Rural Health Clinics was last updated on September 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.