Susannah Reay Elton, PA-C
Physician Assistant in Beaumont, CA. Individual provider (NPI-1).
NPI number1063452811
StatusActive
Last updated in NPPESMar 20, 2020
Details
- NPI
- 1063452811
- Entity type
- Individual (NPI-1)
- Name
- Ms. Susannah Reay Elton
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 8, 2006
- Certification date
- Mar 20, 2020
- Last updated
- Mar 20, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA17116 | CA | Yes |
Practice location
81 Highland Springs AveBeaumont, CA 92223-3170
Phone 951-845-0313
Mailing address
Po Box 10069San Bernardino, CA 92423-0069
Phone 909-335-4188
Other practice locations
7000 Boulder Ave
Highland, CA 92346-3348
Highland, CA 92346-3348
Phone 909-862-1191
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 8 Physician Assistant providers in Beaumont · All 555 providers in Beaumont
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