NPIMap

Individual provider Active NPI

Robert Neal Suares Jr., M.D.

  • Family Medicine Physician
  • Greenville, MS
National Provider Identifier
1275733636
Registry record updated Dec 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
660-L Issued in MS
Practice address
344 Arnold Ave
Greenville, MS 38701-4711
Phone
(662) 332-8131
NPI assigned
Jul 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 660-L MS Primary

Addresses

Primary practice location

344 Arnold Ave
Greenville, MS 38701-4711

Mailing address

PO Box 972
Greenville, MS 38702-0972
Phone (662) 334-9829

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110722000608 MS Practitioner - Internal Medicine 7012053317 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Delta Family Medical Services IncGroup PAC ID 0749458487, 7 clinicians

Practice addresses (Care Compare)

1554 S Colorado St
Greenville, MS 38703-7219
Phone (662) 334-8557

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
660-LMSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Delta Family Medical Services Inc CurrentSince Apr 14, 2011 Accepting new patients
Delta Health System Past Accepting new patients
Prior Radiology Services PA Past Accepting new patients

Locations

1554 S Colorado St
Greenville, MS 38703
Phone (662) 334-8557

344 Arnold Ave
Greenville, MS 38701
Phone (662) 332-8131

Organizations & group practices 4

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325116800000",
    "number": "1275733636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 972",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387020972",
            "telephone_number": "662-334-9829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 ARNOLD AVE",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387014711",
            "telephone_number": "662-332-8131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUARES",
        "first_name": "ROBERT",
        "middle_name": "NEAL",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-23",
        "last_updated": "2011-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "660-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, MS

Sources for this page

Verify at the official NPI Registry.