Individual provider Active NPI

Carlos Julio Suarez Medina, RN, BSN, MSN

  • Registered Nurse
  • San Juan, PR
National Provider Identifier
1427597335
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
80463 Issued in PR
Practice address
Calle Maga Final Pabellon G
Terreno Psiquiatria Estatal
San Juan, PR 00921
Phone
(787) 754-4100
NPI assigned
Feb 13, 2017
Last updated
May 24, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 80463 PR
Registered Nurse 163W00000X 80463 PR Primary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 80463 PR
Psychiatric/Mental Health Registered Nurse 163WP0808X 80463 PR
Ambulatory Care Registered Nurse 163WP2201X 80463 PR

Addresses

Primary practice location

Calle Maga Final Pabellon G
Terreno Psiquiatria Estatal
San Juan, PR 00921

Mailing address

444 Condominio de Diego
Apt 501
San Juan, PR 00923

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
Credentials
Bachelor on Science - Nursing, Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
80463PRMDAddiction (Substance Use Disorder) Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1427597335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 CONDOMINIO DE DIEGO",
            "address_2": "APT 501",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE MAGA FINAL PABELLON G",
            "address_2": "TERRENO PSIQUIATRIA ESTATAL",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00921",
            "telephone_number": "787-754-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUAREZ MEDINA",
        "first_name": "CARLOS",
        "middle_name": "JULIO",
        "name_prefix": "Mr.",
        "credential": "RN, BSN, MSN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-13",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "PR",
            "license": "80463",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PR",
            "license": "80463",
            "primary": true
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "PR",
            "license": "80463",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "PR",
            "license": "80463",
            "primary": false
        },
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "PR",
            "license": "80463",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.