Individual provider Active NPI

Solomon Suede, DO

  • Pediatrics Physician
  • East Orange, NJ
National Provider Identifier
1023646130
Registry record updated Nov 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
324175 Issued in NY
Practice address
444 William St
East Orange, NJ 07017-2213
Phone
(973) 483-1300
NPI assigned
Apr 1, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 324175 NY Primary

Addresses

Primary practice location

444 William St
East Orange, NJ 07017-2213

Mailing address

4640 Bay Pkwy
Brooklyn, NY 11230-3333

Other practice location 1

Maimonides Medical Center
4802 10th Avenue
Brooklyn, NY 11219
Phone (718) 283-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260508003246 NJ Practitioner - Pediatric Medicine 4183192099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Touro Un Col of Osteopathic Medicine, New York, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

741 Broadway
Newark, NJ 07104-4390

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
324175NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Newark Community Health Centers, Inc Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HBFIAA

Organizations & group practices 2

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": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731196800000",
    "number": "1023646130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4640 BAY PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112303333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 WILLIAM ST",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070172213",
            "telephone_number": "973-483-1300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Maimonides Medical Center",
            "address_2": "4802 10th Avenue",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "11219",
            "country_code": "US",
            "telephone_number": "718-283-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUEDE",
        "first_name": "SOLOMON",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-01",
        "last_updated": "2024-11-10",
        "certification_date": "2024-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "324175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Orange, NJ

Sources for this page

Verify at the official NPI Registry.