Nina Gloria Suh, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

20596 Issued in CA

Practice address

18564 US Highway 18 Ste 103104
Apple Valley, CA 92307-2312

Phone

(760) 242-9262

NPI assigned

Oct 28, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Physician Assistant

Education

Loma Linda University School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Trident Medical Group IncGroup PAC ID 6608212899, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ninasuh@chai.allscriptsdirect.net

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.

• Trident Medical Group Inc.

  • Internal Medicine Physician
  • Apple Valley, CA
  • NPI 1093498230
  Medicare reassignment Care Compare group NPD
• Choice Healthcare Associates, Inc.

  • Exclusive Provider Organization
  • Apple Valley, CA
  • NPI 1194964361
  Medicare reassignment

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

{
    "created_epoch": "1256688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1104152966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19111 TOWN CENTER DR",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923088989",
            "telephone_number": "760-242-7777",
            "fax_number": "760-242-2658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18564 US HIGHWAY 18 STE 103104",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072312",
            "telephone_number": "760-242-9262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUH",
        "first_name": "NINA",
        "middle_name": "GLORIA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-28",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "20596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT LICENSE NUMBER",
            "identifier": "20506",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kim D Strong
• Diane Strother
• Athzyry L Suarez Acosta
• Victoria Abigail Suarez
• Latora Subani
• Philip Suh, PA-C
• Sukalpa John Dutta, MD, Inc.
• Orawan Sukavachana, M.D.
• Sumathi Chandrashekhar,DMD,a Professional Corporation
• Sun Choi DDS Inc

• Physician Assistant in Apple Valley, CA
• Providers in Apple Valley, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.