Individual provider Active NPI

Michael James Suah, M.D.

  • Dermatology Physician
  • Ormond Beach, FL
National Provider Identifier
1114912466
Registry record updated Sep 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME76773 Issued in FL
Practice address
400 Lakebridge Plaza Dr
Ormond Beach, FL 32174-5157
Phone
(638) 667-7904
Fax
(386) 677-3083
NPI assigned
Sep 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X ME76773 FL Primary

Addresses

Primary practice location

400 Lakebridge Plaza Dr
Ormond Beach, FL 32174-5157

Mailing address

400 Lakebridge Plaza Dr
Ormond Beach, FL 32174-5157
Phone (638) 667-7904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Howard University College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

400 Lakebridge Plaza Dr
Ormond Beach, FL 32174-5157

Hospital & facility affiliations

  • Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068

Merit-based Incentive Payment System (MIPS)

Final score
90.62 of 100Reported as group
Quality
100
Promoting interoperability
95
Improvement activities
40
Cost
72.89

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision200
Removal of skin lesions1991
Removal or shaving of skin growth20
Skin biopsy645

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Parks Dermatology Center LLC Dermatology CurrentSince Aug 6, 2001 Accepting new patients

Locations

400 Lakebridge Plaza Dr
Ormond Beach, FL 32174
Phone (386) 677-9044

1175 Dunlawton Ave
Ste 102
Port Orange, FL 32127
Phone (386) 316-8092

Organizations & group practices 1

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 2

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": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473811200000",
    "number": "1114912466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 LAKEBRIDGE PLAZA DR",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745157",
            "telephone_number": "638-667-7904",
            "fax_number": "386-677-3083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 LAKEBRIDGE PLAZA DR",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745157",
            "telephone_number": "638-667-7904",
            "fax_number": "386-677-3083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUAH",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2016-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME76773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

Verify at the official NPI Registry.