Individual provider Active NPI

Olimpia P Suciu, PA

  • Physician Assistant
  • Lowell, MA
National Provider Identifier
1013259381
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA4656 Issued in MA
Practice address
275 Varnum Ave Ste 201
Lowell, MA 01854-2141
Phone
(978) 452-9700
Fax
(978) 441-6075
NPI assigned
Mar 25, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 493526 MA
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA4656 MA Primary

Addresses

Primary practice location

275 Varnum Ave Ste 201
Lowell, MA 01854-2141

Mailing address

275 Varnum Ave Ste 201
Lowell, MA 01854-2141
Phone (978) 452-9700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20130507000162 MA Practitioner - Physician Assistant 4385881549 Reassigns benefits to 2 organizations

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
Riverside Medical Group PCGroup PAC ID 5193612919, 12 clinicians

Practice addresses (Care Compare)

275 Varnum Ave
Lowell, MA 01854-2109

275 Varnum Ave
Suite 201
Lowell, MA 01854-2141
Phone (978) 452-9700

Hospital & facility affiliations

  • Lowell General Hospital Hospital, Lowell, MA, CCN 220063

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
493526MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Diagnostic Services, Inc Multi-Specialty PastSince Jan 24, 2021 Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1364169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1013259381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 VARNUM AVE STE 201",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018542141",
            "telephone_number": "978-452-9700",
            "fax_number": "978-441-6075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 VARNUM AVE STE 201",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018542141",
            "telephone_number": "978-452-9700",
            "fax_number": "978-441-6075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUCIU",
        "first_name": "OLIMPIA",
        "middle_name": "P",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-25",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "493526",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA4656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

Verify at the official NPI Registry.