Individual provider Active NPI

Suzanne Essengue Belibi, M.D.

  • Pediatric Allergy/Immunology Physician
  • Aurora, CO
National Provider Identifier
1265558571
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Allergy/Immunology PhysicianTaxonomy code 2080P0201X
License
46240 Issued in CO
Practice address
3191 S Vaughn Way Ste 101
Aurora, CO 80014-3505
Phone
(303) 755-4600
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology (Internal Medicine) Physician 207RA0201X 46240 CO
Pediatric Allergy/Immunology Physician 2080P0201X 46240 CO Primary

Addresses

Primary practice location

3191 S Vaughn Way Ste 101
Aurora, CO 80014-3505

Mailing address

3191 S Vaughn Way Ste 101
Aurora, CO 80014-3505
Phone (303) 755-4600

Other identifiers 1

IdentifierTypeStateIssuer
87872269MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL updox Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20110425000407 CO Practitioner - Allergy/ImmunologyPractitioner - Pediatric Medicine 5395920052 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46240COMDPediatric Allergy/Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Health Pharmacy Current Accepting new patients
Grace Health Clinic CurrentSince Feb 24, 2021 Accepting new patients
Grace Health Pharmacy Current Accepting new patients
Grace Clinic Laboratory PastSince Feb 24, 2021 Accepting new patients
Grace Medical Supplies LTD PastSince Aug 1, 2016 Accepting new patients

Locations

3191 S Vaughn Way
Aurora, CO 80014
Phone (303) 495-5047

3191 S Vaughn Way
Unit 101
Aurora, CO 80014

3191 S Vaughn Way
Ste 101
Aurora, CO 80014
Phone (303) 343-4600

10 S Havana St
Ste 103
Aurora, CO 80012
Phone (303) 343-4600

Organizations & group practices 5

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1265558571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3191 S VAUGHN WAY STE 101",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800143505",
            "telephone_number": "303-755-4600",
            "fax_number": "303-745-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3191 S VAUGHN WAY STE 101",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800143505",
            "telephone_number": "303-755-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESSENGUE BELIBI",
        "first_name": "SUZANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0201X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": "CO",
            "license": "46240",
            "primary": false
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "CO",
            "license": "46240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87872269",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "updox",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "updox",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "updox",
            "address_1": "3191 S Vaughn Way Ste 101",
            "city": "Aurora",
            "state": "CO",
            "country_code": "US",
            "postal_code": "800143505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.