Individual provider Active NPI

Nathaly Antigua Suarez, PA-C

  • Physician Assistant
  • Lakeland, FL
National Provider Identifier
1003176322
Registry record updated May 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9106590 Issued in FL
Practice address
1157 Thomasville Cir
Lakeland, FL 33811-3400
Phone
(863) 934-6230
NPI assigned
May 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9106590 FL Primary

Addresses

Primary practice location

1157 Thomasville Cir
Lakeland, FL 33811-3400

Mailing address

1157 Thomasville Cir
Lakeland, FL 33811-3400
Phone (863) 934-6230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141220000212 FL Practitioner - Physician Assistant 7517280670 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suncoast Community Health Centers Inc 30 clinicians

Practice addresses (Care Compare)

801 E Baker St
Plant City, FL 33563-3652
Phone (813) 653-6100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9106590FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Suncoast Community Health Centers Inc CurrentSince Oct 8, 2014 Accepting new patients
Suncoast Community Health Centers, Inc CurrentSince Oct 8, 2014 Accepting new patients
Suncoast Community Health Centers Inc Past Accepting new patients

Locations

801 E Baker St
Plant City, FL 33563
Phone (813) 349-7649

13110 Elk Mountain Dr
Riverview, FL 33579
Phone (813) 349-7567

2814 14th Ave SE
Ruskin, FL 33570
Phone (813) 349-7800

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BHAFAA/Endpoint/BHAFAA
  • Direct secure messaging: nathaly.antiguasuarez@suncoastchc.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/BHAFAA

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337558400000",
    "number": "1003176322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1157 THOMASVILLE CIR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338113400",
            "telephone_number": "863-934-6230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1157 THOMASVILLE CIR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338113400",
            "telephone_number": "863-934-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTIGUA SUAREZ",
        "first_name": "NATHALY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-21",
        "last_updated": "2012-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.