Individual provider Active NPI

Adam Suchecki, PA-C

  • Surgical Physician Assistant
  • Brandon, FL
National Provider Identifier
1134590391
Registry record updated Oct 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9109137 Issued in FL
Practice address
1007 Professional Park Dr
Brandon, FL 33511-4886
Phone
(813) 651-3300
Fax
(813) 651-4455
NPI assigned
Oct 14, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9109137 FL Primary

Addresses

Primary practice location

1007 Professional Park Dr
Brandon, FL 33511-4886

Mailing address

1007 Professional Park Dr
Brandon, FL 33511-4886
Phone (813) 651-3300

Other identifiers 1

IdentifierTypeStateIssuer
PA9109137OtherFLLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, SD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171109001967 TX Practitioner - Physician Assistant 4082916846 Reassigns benefits to 2 organizations
I20230223001654 SD Practitioner - Physician Assistant 4082916846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acute Care Surgery of South Dakota PCGroup PAC ID 5698195030, 67 clinicians
Rise Up Rehab, LLCGroup PAC ID 3274861497, 118 clinicians
BHS Physicians Network, IncGroup PAC ID 7315019593, 702 clinicians

Practice addresses (Care Compare)

1635 Caregiver Cir
Rapid City, SD 57702-8529
Phone (605) 755-6100

16400 Blanco Rd
San Antonio, TX 78232-1902
Phone (210) 572-4954

353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone (605) 755-1000

3903 Wiseman Blvd
San Antonio, TX 78251-4402
Phone (210) 946-1400

6704 Randolph Blvd
Live Oak, TX 78233-4222
Phone (210) 477-5151

8715 Village Dr
Suite 120
San Antonio, TX 78217-5425
Phone (210) 477-5151

8811 Village Dr
San Antonio, TX 78217-5415

Hospital & facility affiliations

  • Baptist Medical Center Hospital, San Antonio, TX, CCN 450058

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
BHS Physicians Network, Inc CurrentSince Nov 7, 2019 Accepting new patients
BHS Physicians Network, Inc CurrentSince Nov 7, 2019 Accepting new patients
BHS Specialty Network Inc Past Accepting new patients

Locations

12709 Toepperwein Rd
Ste 101
Live Oak, TX 78233

6704 Randolph Blvd
Live Oak, TX 78233
Phone (210) 656-9506

18707 Hardy Oak Blvd
Ste 415
San Antonio, TX 78258
Phone 2104775151 ext. 108

8715 Village Dr
Ste 120
San Antonio, TX 78217
Phone 2104775151 ext. 108

3903 Wiseman Blvd
Ste 100
San Antonio, TX 78251
Phone (210) 681-0126

3903 Wiseman Blvd
San Antonio, TX 78251
Phone (210) 681-0126

17766 Verde Pkwy
Ste 150
Selma, TX 78154

Interoperability endpoints

  • Direct secure messaging: adam.suchecki.1@1438.direct.athenahealth.com

Organizations & group practices 6

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": "1444780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444780800000",
    "number": "1134590391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 PROFESSIONAL PARK DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114886",
            "telephone_number": "813-651-3300",
            "fax_number": "813-651-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 PROFESSIONAL PARK DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114886",
            "telephone_number": "813-651-3300",
            "fax_number": "813-651-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUCHECKI",
        "first_name": "ADAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-14",
        "last_updated": "2015-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9109137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA9109137",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.