Individual provider Active NPI

Suzanne Yuri Wada, MD

  • Infectious Disease Physician
  • Dallas, TX
National Provider Identifier
1427012152
Registry record updated Mar 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
K2621 Issued in TX
Practice address
3409 Worth St Ste 710
Dallas, TX 75246-2060
Phone
(214) 823-2533
NPI assigned
Apr 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X K2621 TX Primary

Addresses

Primary practice location

3409 Worth St Ste 710
Dallas, TX 75246-2060

Mailing address

3409 Worth St Ste 710
Dallas, TX 75246-2060
Phone (214) 823-2533

Other identifiers 1

IdentifierTypeStateIssuer
046975101MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100218000308 TX Practitioner - Infectious DiseasePractitioner - Internal Medicine 2567506223 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Temple University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2377 N Stemmon Fwy 263
Dallas County Health Human Services
Dallas, TX 75207-2710
Phone (214) 819-1865

2377 N Stemmons Fwy
Suite 263
Dallas, TX 75207-2710

2377 N Stemmons Fwy 502
Dallas County Health Human Services
Dallas, TX 75207-2710
Phone (214) 819-2023

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Texas Infectious Diseases Consultants CurrentSince Jul 18, 2016 Accepting new patients
County of Dallas CurrentSince Mar 21, 2022 Accepting new patients
North Texas Infectious Disaeases Consultants, PA CurrentSince May 10, 2020 Accepting new patients

Locations

2377 N Stemmons Fwy
Ste 263
Dallas, TX 75207
Phone (214) 819-1865

3409 Worth St
Ste 710
Dallas, TX 75246
Phone (214) 823-2533

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.60208

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.

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520467200000",
    "number": "1427012152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3409 WORTH ST STE 710",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462060",
            "telephone_number": "214-823-2533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3409 WORTH ST STE 710",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462060",
            "telephone_number": "214-823-2533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADA",
        "first_name": "SUZANNE",
        "middle_name": "YURI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2018-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TX",
            "license": "K2621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046975101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.