Active NPI
Shaun P Suarez
- Family Nurse Practitioner
- Hemet, CA
National Provider Identifier
1265864557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95017083
- Practice address
- 540 N San Jacinto St Ste P
Hemet, CA 92543-3154 - Phone
- (951) 929-4000
- Fax
- (951) 929-4100
- NPI assigned
- Aug 8, 2013
- Last updated
- Jul 21, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95017083 | CA | Primary |
| Registered Nurse | 163W00000X | 833375 | CA |
Addresses
Primary practice location
540 N San Jacinto St Ste P
Hemet, CA 92543-3154
Mailing address
540 N San Jacinto St Ste P
Hemet, CA 92543-3154
Phone (951) 929-4000
Other practice location 1
400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-3144
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 833375 | CA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626825600000",
"number": "1265864557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "540 N SAN JACINTO ST STE P",
"city": "HEMET",
"state": "CA",
"postal_code": "925433154",
"telephone_number": "951-929-4000",
"fax_number": "951-929-4100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "540 N SAN JACINTO ST STE P",
"city": "HEMET",
"state": "CA",
"postal_code": "925433154",
"telephone_number": "951-929-4000",
"fax_number": "951-929-4100"
}
],
"practiceLocations": [
{
"address_1": "400 N Pepper Ave",
"address_purpose": "LOCATION",
"city": "Colton",
"state": "CA",
"postal_code": "923241801",
"country_code": "US",
"telephone_number": "909-580-3144",
"fax_number": "909-580-2165",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SUAREZ",
"first_name": "SHAUN",
"middle_name": "P",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-08-08",
"last_updated": "2021-07-21",
"certification_date": "2021-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95017083",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "833375",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hemet, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.