Individual provider Active NPI

Stephen P Suzuki, MD

  • Orthopaedic Surgery Physician
  • Riverside, CA
National Provider Identifier
1114923968
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
G59716 Issued in CA
Practice address
4354 Latham St Ste 100
Riverside, CA 92501-1777
Phone
(951) 683-0650
Fax
(951) 774-4610
NPI assigned
Jun 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X G59716 CA
Orthopaedic Surgery Physician 207X00000X G59716 CA Primary

Addresses

Primary practice location

4354 Latham St Ste 100
Riverside, CA 92501-1777

Mailing address

4354 Latham St Ste 100
Riverside, CA 92501-1777
Phone (951) 683-0650

Other identifiers 1

IdentifierTypeStateIssuer
200009735OtherCARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080528000477 CA Practitioner - Orthopedic Surgery 2264502608

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G59716CAMDAdult Reconstructive Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Hospital of Riverside LLC Past Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients
San Gorgonio Memorial Hospital Past 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.

NPI Registry JSON

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1114923968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4354 LATHAM ST STE 100",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925011777",
            "telephone_number": "951-683-0650",
            "fax_number": "951-774-4610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4354 LATHAM ST STE 100",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925011777",
            "telephone_number": "951-683-0650",
            "fax_number": "951-774-4610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUZUKI",
        "first_name": "STEPHEN",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "CA",
            "license": "G59716",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G59716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "200009735",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.