Individual provider Active NPI

Noel O Suanes, M.D.

  • Pediatrics Physician
  • Vincennes, IN
National Provider Identifier
1265400915
Registry record updated Mar 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01050526A Issued in IN
Practice address
528 N 1St St
Vincennes, IN 47591-1402
Phone
(812) 882-4434
Fax
(812) 885-6318
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01050526A IN Primary

Addresses

Primary practice location

528 N 1St St
Vincennes, IN 47591-1402

Mailing address

528 N 1St St
Vincennes, IN 47591-1402
Phone (812) 882-4434

Other identifiers 1

IdentifierTypeStateIssuer
200228390AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20100228000001 IN Practitioner - Pediatric Medicine 8527101948 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01050526AINMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Hospital Physician Services, Inc CurrentSince Jan 1, 2011 Accepting new patients
Good Samaritan Hospital CurrentSince Jan 1, 2011 Accepting new patients
Good Samaritan Hospital Physician Services Inc. Past Accepting new patients

Locations

528 N 1st St
Vincennes, IN 47591
Phone (812) 882-4434

1160 E Saint Clair St
Vincennes, IN 47591
Phone (812) 882-1064

406 N 1st St
Vincennes, IN 47591
Phone (812) 882-1106

520 S 7th St
Vincennes, IN 47591
Phone (812) 885-3280

Interoperability endpoints

  • Direct secure messaging: nsuanes120939@direct.deaconess.com

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427328000000",
    "number": "1265400915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 N 1ST ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475911402",
            "telephone_number": "812-882-4434",
            "fax_number": "812-885-6318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 N 1ST ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475911402",
            "telephone_number": "812-882-4434",
            "fax_number": "812-885-6318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUANES",
        "first_name": "NOEL",
        "middle_name": "O",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2015-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01050526A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200228390A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vincennes, IN

Sources for this page

Verify at the official NPI Registry.