Active NPI
Suja Samuel
- Case Management Registered Nurse
- Martinez, CA
National Provider Identifier
1417329947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Management Registered Nurse
- License
- 666581
- Practice address
- 597 Center Avenue, Suite 200-a
Martinez, CA 94553 - Phone
- (925) 313-6740
- NPI assigned
- Oct 23, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Registered Nurse | 163WC0400X | 666581 | CA | Primary |
Addresses
Primary practice location
597 Center Avenue, Suite 200-a
Martinez, CA 94553
Mailing address
P.O.Box 4738
Antioch, CA 94531
Phone (405) 436-3557
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| F3305375 | Other | CA | DRIVER'S LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 666581 | CA | MD | Case Management Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445558400000",
"number": "1417329947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O.BOX 4738",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "94531",
"telephone_number": "405-436-3557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "597 CENTER AVENUE, SUITE 200-A",
"city": "MARTINEZ",
"state": "CA",
"postal_code": "94553",
"telephone_number": "925-313-6740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUEL",
"first_name": "SUJA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-23",
"last_updated": "2015-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Case Management",
"state": "CA",
"license": "666581",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVER'S LICENSE",
"identifier": "F3305375",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Martinez, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.