Individual provider Active NPI

Lizanell Irizarry Suarez

  • Psychiatry Physician
  • Aibonito, PR
National Provider Identifier
1174985105
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
21297 Issued in PR
Practice address
Calle Sargento Gerardo Santiago Carr 14
Aibonito, PR 00705
Phone
(787) 714-2462
NPI assigned
Mar 29, 2016
Last updated
May 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 21297 PR
Student in an Organized Health Care Education/Training Program 390200000X 33736-R PR
Psychiatry Physician 2084P0800X 21297 PR Primary

Addresses

Primary practice location

Calle Sargento Gerardo Santiago Carr 14
Aibonito, PR 00705

Mailing address

PO Box 3592
Carolina, PR 00984-3592
Phone (787) 632-2417

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20240912000502 PR Practitioner - Psychiatry 0143760256 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33736-RPRMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Mennonite General Hospital Inc. CurrentSince Jul 20, 2024 Accepting new patients
Mennonite General Hospital Inc. CurrentSince Jul 20, 2024 Accepting new patients
Mennonite General Hospital Inc Current 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1174985105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3592",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009843592",
            "telephone_number": "787-632-2417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE SARGENTO GERARDO SANTIAGO CARR 14",
            "city": "AIBONITO",
            "state": "PR",
            "postal_code": "00705",
            "telephone_number": "787-714-2462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRIZARRY SUAREZ",
        "first_name": "LIZANELL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-29",
        "last_updated": "2024-05-07",
        "certification_date": "2024-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "21297",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PR",
            "license": "33736-R",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PR",
            "license": "21297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aibonito, PR

Sources for this page

Verify at the official NPI Registry.