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PATRICIA L SUTTER CNP
NPI 1609395425
Nurse Practitioner - Family in Union City, OH

Active since September 13, 2017PECOS EnrolledAccepts Medicare Assignment
622 E ELM ST, UNION CITY, OH 45390(937) 968-7416(937) 968-3026 Get Directions Write a Review

NPPES record last updated: July 17, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 17, 2024, Sep 29, 2022, Sep 8, 2021 and 4 more (7 updates tracked since 2017).

About Patricia L Sutter Cnp NPPES

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

PATRICIA L SUTTER CNP (NPI 1609395425) is an individual family provider in Union City, Ohio, licensed in Ohio (APRN.CNP.021797) and active in the NPI registry since September 2017. She is enrolled in Medicare PECOS, is affiliated with Indiana University Health Jay, Inc., and is a graduate of Other (2017).

NPPES Registry Identity

NPI1609395425
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NamePATRICIA L SUTTERCredential: CNP
Location Address622 E ELM STUnion City, OH 45390-1722
Mailing Address835 Sweitzer StGreenville, OH 45331-1077 · (937) 569-6996
Phone(937) 968-7416
Fax(937) 968-3026
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateSeptember 13, 2017
Last NPPES UpdateJuly 17, 20247 updates tracked since enumeration
NPPES CertifiedJuly 17, 2024
✔ NPI 1609395425 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in OH · APRN.CNP.021797
622 E ELM ST, Union City, OH 45390
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Patricia L Sutter Cnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6608142369
PECOS Enrollment IDI20171024002760, I20190121000755
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
734 services307 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
170 services110 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
62 services62 patients
Injection of drug or substance under skin or into muscle 96372
This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
61 services29 patients
Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional 99211
This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.
37 services14 patients
Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza 87428
This test uses a method called immunoassay to identify severe acute respiratory syndrome coronavirus and influenza. It works by detecting specific proteins (antigens) in a sample, like a nasal swab. It's a powerful tool in diagnosing these viral infections.
26 services26 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Indiana University Health Jay, Inc.

Critical Access Hospitals · Portland, IN
OwnershipGovernment - Local
CMS Certification Number151320
Location500 W Votaw StPortland, IN 47371 · Jay County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45390 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Adult Sinusitis: Computerized Tomography (CT) for Acute Sinusitis (Overuse)
Percentage of patients aged 18 years and older with a diagnosis of acute sinusitis who had a computerized tomography (CT) scan of the paranasal sinuses ordered at the time of diagnosis or received within 28 days after date of diagnosis
Lower rates are better for this measure.
0%85 patients
Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
36%253 patients2/55-star benchmark: 92%
Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
25%287 patients2/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
13%468 patients1/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
21%121 patients1/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%2,576 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
98%8,804 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
33%493 patients2/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%496 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
90%1,111 patients4/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
100%1,111 patients5/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
8%1,111 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
11%1,111 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 8

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
6 suppliers64 claims106 services$5.63 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
4 suppliers12 claims12 services$1.13 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
3 suppliers47 claims47 services$20.33 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
2 suppliers16 claims16 services$6.69 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
5 suppliers67 claims68 services$111.73 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
2 suppliers14 claims15 services$37.92 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SUSAN K PYLE M.D.
Family Medicine
622 E ELM ST
UNION CITY, OH 45390
Darke County (937) 968-7946

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 Patricia Sutter's NPI number?

The NPI number for Patricia Sutter is 1609395425. It was assigned to this individual provider in the NPPES registry on September 13, 2017.

Where is Patricia Sutter located?

Patricia Sutter practices at 622 E Elm St, Union City, OH 45390. The listed phone number is (937) 968-7416.

What is Patricia Sutter's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Patricia Sutter enrolled in Medicare?

Yes. Patricia Sutter is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Patricia Sutter accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 3 other insurers list Patricia Sutter 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.

Is Patricia Sutter affiliated with any hospitals?

According to CMS data, Patricia Sutter is affiliated with Indiana University Health Jay, Inc..

When was this NPI record last updated?

The NPPES record for Patricia Sutter was last updated on July 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.