NPIMap

Individual provider Active NPI

Jacob A Suazo, MD

  • Family Medicine Physician
  • Redding, CA
National Provider Identifier
1295398451
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
177142 Issued in CA
Practice address
1035 Placer St
Redding, CA 96001-1125
Phone
(530) 246-5710
Fax
(530) 245-1068
NPI assigned
Apr 15, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 177142 CA Primary

Addresses

Primary practice location

1035 Placer St
Redding, CA 96001-1125

Mailing address

1013 Echo Rd Apt 11
Redding, CA 96002-2752
Phone (701) 610-1133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20210526001786 CA Practitioner - Family Practice 3678972593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shasta Community Health CenterGroup PAC ID 3870579816, 63 clinicians

Practice addresses (Care Compare)

1035 Placer St
Redding, CA 96001-1170
Phone (530) 246-5796

1201 Industrial St
Redding, CA 96002-0757
Phone (530) 229-5000

2965 E St
Anderson, CA 96007-3481
Phone (530) 378-0486

4215 Front St
Shasta Lake, CA 96019-9430
Phone (530) 275-9168

Hospital & facility affiliations

  • Interim Healthcare Home health agency, Redding, CA, CCN 557630
  • Accentcare Home Health of California, Inc Home health agency, Redding, CA, CCN 557273
  • Valley View Healthcare Services LLC Home health agency, Chico, CA, CCN 559751
  • Mercy Home Care Home health agency, Redding, CA, CCN 057609
  • Aspire Home Healthcare of Northern California, Inc Home health agency, Yuba City, CA, CCN 059707
  • Shasta Regional Medical Center Hospital, Redding, CA, CCN 050764
  • Mercy Medical Center Redding Hospital, Redding, CA, CCN 050280
  • Oroville Hospital Hospital, Oroville, CA, CCN 050030

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
177142CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shasta Community Health Center CurrentSince Apr 1, 2021 Accepting new patients
Shasta Community Health Center Current Accepting new patients
Shasta Community Health Center Family Medicine CurrentSince Apr 1, 2021 Accepting new patients

Locations

1035 Placer St
Redding, CA 96001

Interoperability endpoints

  • Direct secure messaging: jacob.suazomd.p1@direct.schc.nextgenshare.com

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1295398451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 ECHO RD APT 11",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960022752",
            "telephone_number": "701-610-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 PLACER ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011125",
            "telephone_number": "530-246-5710",
            "fax_number": "530-245-1068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUAZO",
        "first_name": "JACOB",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-15",
        "last_updated": "2022-07-28",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "177142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.