Kelly Jennifer Suarez, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

25MP00465900 Issued in NJ

Practice address

480 Red Hill Rd
Middletown, NJ 07748

Phone

(848) 225-6331

Fax

(212) 717-3169

NPI assigned

May 17, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, NY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MSK MonmouthGroup PAC ID 1153619291, 300 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital for Cancer and Allied Diseases Hospital, New York, NY, CCN 330154

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989

Interoperability endpoints

• Direct secure messaging: ksuarez23149@mskcc.direct-ci.com

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.

• MSK Monmouth

  • Medical Oncology Physician
  • Middletown, NJ
  • NPI 1922459163
  Medicare reassignment Care Compare group
• MSK Ralph Lauren Center

  • Medical Oncology Physician
  • New York, NY
  • NPI 1316406879
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Memorial Hospital for Cancer & Allied Diseases

  • General Acute Care Hospital
  • Basking Ridge, NJ
  • NPI 1659385474
  Care Compare affiliation
• Memorial Sloan Kettering Bergen

  • General Acute Care Hospital
  • Montvale, NJ
  • NPI 1841650330
  Care Compare affiliation
• Memorial Sloan Kettering Monmouth

  • General Acute Care Hospital
  • Middletown, NJ
  • NPI 1528428521
  Care Compare affiliation
• Memorial Hospital for Cancer and Allied Diseases

  • General Acute Care Hospital
  • New York, NY
  • NPI 1700887411
  Care Compare affiliation
• Ralph Lauren Center for Cancer Care and Prevention

  • Special Hospital
  • New York, NY
  • NPI 1770046351
  Care Compare affiliation

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

{
    "created_epoch": "1274054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1427376342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 GODWIN AVE UNIT 1",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503709",
            "telephone_number": "786-296-2309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 RED HILL RD",
            "city": "MIDDLETOWN",
            "state": "NJ",
            "postal_code": "07748",
            "telephone_number": "848-225-6331",
            "fax_number": "212-717-3169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUAREZ",
        "first_name": "KELLY",
        "middle_name": "JENNIFER",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-17",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9105022",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00465900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Khalil M Suaray, M.D.
• Khayriyyah N Suluki
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• Surfside Smile Company LLC
• Eleonora Takhtaganov
• Talk of the Town Speech and Reading Center

• Surgical Physician Assistant in Middletown, NJ
• Providers in Middletown, NJ by specialty
• Surgical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.