Individual provider Active NPI

Jon David Suarez, M.S., F/AAA

  • Audiologist
  • Potsdam, NY
National Provider Identifier
1235218256
Registry record updated Feb 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
002042-1 Issued in NY
Practice address
6609 State Route 56
Potsdam, NY 13676-3574
Phone
(315) 508-4327
Fax
(315) 262-0300
NPI assigned
Nov 2, 2006
Last updated
Feb 20, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 002042-1 NY Primary

Addresses

Primary practice location

6609 State Route 56
Potsdam, NY 13676-3574

Mailing address

6609 State Route 56
Potsdam, NY 13676-3547
Phone (315) 508-4327

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070723000303 NY Practitioner - Qualified Audiologist 9931200847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State Hearing and Audiology PCGroup PAC ID 3173758711, 3 clinicians

Practice addresses (Care Compare)

6609 State Hwy 56
Potsdam, NY 13676-3510
Phone (315) 508-4327

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
002042-1NYMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
State Hearing and Audiology, PC CurrentSince Aug 7, 2013 Accepting new patients
State Hearing and Audiology, PC Past Accepting new patients
Plattsburgh State University Speech and Hearing Center PastSince May 1, 2007 Accepting new patients

Locations

3982 State Route 11
Malone, NY 12953
Phone (518) 753-3277

6609 State Highway 56
Potsdam, NY 13676
Phone (315) 508-4327

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487548800000",
    "number": "1235218256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6609 STATE ROUTE 56",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136763547",
            "telephone_number": "315-508-4327",
            "fax_number": "315-262-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6609 STATE ROUTE 56",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136763574",
            "telephone_number": "315-508-4327",
            "fax_number": "315-262-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUAREZ",
        "first_name": "JON",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "M.S., F/AAA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2017-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "002042-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Potsdam, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.