Individual provider Active NPI

Suzanne Numan, MD

  • Pediatric Anesthesiology Physician
  • Albuquerque, NM
National Provider Identifier
1285950501
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
MD2014-0059 Issued in NM
Practice address
4520 Montgomery Blvd NE
Albuquerque, NM 87109-1217
Phone
(505) 308-3145
NPI assigned
Apr 12, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Anesthesiology Physician 207LP3000X MD2014-0059 NM Primary

Addresses

Primary practice location

4520 Montgomery Blvd NE
Albuquerque, NM 87109-1217

Mailing address

6417 Kings Canyon CV NE
Rio Rancho, NM 87144-7673
Phone (505) 353-7480

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180529002741 NM Practitioner - Anesthesiology 3779715776 Reassigns benefits to 1 organization
I20230417000021 CA Practitioner - Anesthesiology 3779715776 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Mar 13, 2023 Accepting new patients
Southern California Permanente Medical Group CurrentSince Mar 13, 2023 Accepting new patients
Main Street Anesthesia of New Mexico, LLC Anesthesiology CurrentSince Jan 1, 2019 Accepting new patients

Locations

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

601 Martin Luther King Ave NE
Albuquerque, NM 87102
Phone (505) 727-8040

117 E 19th St
Roswell, NM 88201
Phone (505) 727-2000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1271030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1285950501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6417 KINGS CANYON CV NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871447673",
            "telephone_number": "505-353-7480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4520 MONTGOMERY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091217",
            "telephone_number": "505-308-3145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUMAN",
        "first_name": "SUZANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-12",
        "last_updated": "2023-09-26",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "NM",
            "license": "MD2014-0059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10800 Magnolia Ave",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925053043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.