DR. MARY SUSANNE PLACEK (M.D.) – Family Medicine Physician, NPI 1265727515

DR. MARY SUSANNE PLACEK (M.D.) is a healthcare provider. based in Independence, Oregon. specializing in FAMILY PRACTICE, OBSTETRICS/GYNECOLOGY. They hold the professional credentials M.D.. They hold a License No. MR-1208 (ID). The NPI Number for DR. MARY SUSANNE PLACEK (M.D.) is 1265727515

Main info

Female
Sole Proprietor
15 Years Of Experience
Accepts Medicare Assignment
Name
DR. MARY SUSANNE PLACEK (M.D.)
NPI
1265727515
Phone
(503) 838-1133
Address
PO BOX 309
Enumeration Date
15 June 2011
Last Update Date
4 September 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5038381182
Graduation Year
2011 (15 years ago)
PAC ID
4981859436
Group Practice PAC ID
8628986668
Professional Enrollment ID
I20150303000014
Address ID
OR973612370MO512XXEXXX402
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience51
Completeness75
Years active:14State licenses:2Digital endpointsOther names

2,081 FAMILY PRACTICE in OR

Provider Addresses for DR. MARY SUSANNE PLACEK (M.D.)

  • PO BOX 309

    INDEPENDENCE, OR 973510309

    Phone: (503) 838-1133

    Fax: (503) 838-5138

    Type: Mailing

  • 1430 MONMOUTH ST

    INDEPENDENCE, OR 973511127

    Phone: (503) 838-1133

    Fax: (503) 838-5138

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-03-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20150303000014IFamily PracticeORTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes14893$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit7878$0
G0008Administration of influenza virus vaccine3939$0
99213Established patient office or other outpatient visit, 20-29 minutes3830$0
90662Influenza vaccine split virus, preservative free3333$0
View full utilization report →

Insurance plans in this area (ZIP 97351)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8628986668View full group profile
NameSpecialtyState
-OR
U R O L O G YOR
Physician AssistantOR
A N E S T H E S I O L O G YWA
A N E S T H E S I O L O G YMT
Family PracticeOR
Plastic And Reconstructive SurgeryOR
Nurse PractitionerOR
A N E S T H E S I O L O G YWA
-OR

Reviews

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Frequently asked questions

How do I look up DR. MARY SUSANNE PLACEK (M.D.) by NPI?
Use NPI 1265727515 when you need to reference DR. MARY SUSANNE PLACEK (M.D.) in forms, claims, or directories.
Is DR. MARY SUSANNE PLACEK (M.D.) currently active in the NPI registry?
CMS-published data lists DR. MARY SUSANNE PLACEK (M.D.) as an active registrant.
What field does DR. MARY SUSANNE PLACEK (M.D.) work in?
You can think of DR. MARY SUSANNE PLACEK (M.D.) as practicing within Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Does DR. MARY SUSANNE PLACEK (M.D.) practice in Oregon?
You will see Independence, Oregon on file for DR. MARY SUSANNE PLACEK (M.D.) alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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