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PISETH SUOR PA
NPI 1699054809
Physician Assistant in Stockton, CA

Active since August 05, 2011PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
4873 WEST LN STE A, STOCKTON, CA 95210(209) 472-1515(209) 472-1651 Get Directions Write a Review

NPPES record last updated: August 5, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Piseth Suor Pa NPPES

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

PISETH SUOR PA (NPI 1699054809) is an individual physician assistant in Stockton, California, licensed in California (17756) and active in the NPI registry since August 2011. He is enrolled in Medicare PECOS and is a graduate of University Of California, Davis School Of Medicine (2004).

NPPES Registry Identity

NPI1699054809
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NamePISETH SUORCredential: PA
Location Address4873 WEST LN STE AStockton, CA 95210-4548
Mailing Address4873 West Ln Ste AStockton, CA 95210-4548 · (209) 472-1515 · Fax (209) 472-1651
Phone(209) 472-1515
Fax(209) 472-1651
Sole ProprietorNo
Medical School CMSUniversity Of California, Davis School Of MedicineGraduated 2004
Enumeration DateAugust 5, 2011
✔ NPI 1699054809 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in CA · 17756
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
4873 WEST LN STE A, Stockton, CA 95210
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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

Piseth Suor Pa 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 ID4486870086
PECOS Enrollment IDI20140716001850
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95210 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
$90.32 typical visit price
range $58.87 – $176.60
Typical copayment $22.58 (range $14.71 – $44.15)
Most-billed visit code 99203
Established Patient
$73.16 typical visit price
range $19.28 – $144.60
Typical copayment $18.29 (range $4.82 – $36.15)
Most-billed visit code 99213
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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Improvement Activities40
Cost90.48

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
10 suppliers36 claims89 services$5.11 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
9 suppliers26 claims31 services$0.95 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
2 suppliers15 claims15 services$32.61 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress E0295
DME-Hospital Beds · category DB000N
2 suppliers23 claims23 services$43.74 avg. paid by Medicare
Bed side rails, half length E0305
DME-Hospital Beds · category DB000N
1 supplier18 claims18 services$5.91 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
1 supplier11 claims11 services$12.14 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.

DR. ELVIS AKPENE TANSON D.O.
Family Medicine
4873 WEST LN STE A
STOCKTON, CA 95210
San Joaquin County (298) 472-1515

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 Piseth Suor's NPI number?

The NPI number for Piseth Suor is 1699054809. It was assigned to this individual provider in the NPPES registry on August 5, 2011.

Where is Piseth Suor located?

Piseth Suor practices at 4873 West Ln Ste A, Stockton, CA 95210. The listed phone number is (209) 472-1515.

What is Piseth Suor's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Piseth Suor enrolled in Medicare?

Yes. Piseth Suor 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.

When was this NPI record last updated?

The NPPES record for Piseth Suor was last updated on August 5, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.