Individual provider Active NPI

Sergio Gabriel Suarez, MD

  • Internal Medicine Physician
  • Freeport, NY
National Provider Identifier
1417920091
Registry record updated Feb 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
199943 Issued in NY
Practice address
72 Guy Lombardo Ave
Suite 1
Freeport, NY 11520
Phone
(516) 377-2727
Fax
(516) 377-8088
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 199943 NY Primary

Addresses

Primary practice location

72 Guy Lombardo Ave
Suite 1
Freeport, NY 11520

Mailing address

72 Guy Lombardo Ave
Suite 1
Freeport, NY 11520
Phone (516) 377-2727

Other identifiers 1

IdentifierTypeStateIssuer
01635047MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120103000007 NY Practitioner - Internal Medicine 3678749215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

72 Guy Lombardo Ave
Suite 1
Freeport, NY 11520-3742
Phone (516) 377-2727

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sergio G. Suarez Physician PC Internal Medicine CurrentSince Feb 23, 1998 Accepting new patients
Suarez Family Medicine PLLC CurrentSince Sep 15, 2024 Accepting new patients

Locations

72 Guy Lombardo Ave
Ste 1
Freeport, NY 11520
Phone (516) 377-2727

Organizations & group practices 2

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 1

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297123200000",
    "number": "1417920091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 GUY LOMBARDO AVE",
            "address_2": "SUITE 1",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "11520",
            "telephone_number": "516-377-2727",
            "fax_number": "516-377-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 GUY LOMBARDO AVE",
            "address_2": "SUITE 1",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "11520",
            "telephone_number": "516-377-2727",
            "fax_number": "516-377-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUAREZ",
        "first_name": "SERGIO",
        "middle_name": "GABRIEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2011-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "199943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01635047",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, NY

Sources for this page

Verify at the official NPI Registry.