Individual provider Active NPI

Shaun P Suarez

  • Family Nurse Practitioner
  • Hemet, CA
National Provider Identifier
1265864557
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95017083 Issued in CA
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, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
833375CAMDRegistered 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

Verify at the official NPI Registry.