Organization Active NPI

Suggero Healthcare Services LLC

  • Home Health Agency
  • Upper Marlboro, MD
National Provider Identifier
1447686118
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
SUGGERO HEALTHCARE SERVICES LLC
Practice address
11405 Villa CT
Upper Marlboro, MD 20774-5702
Phone
(718) 309-1190
NPI assigned
Sep 25, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Authorized official

Name
Babatunde Olujobi, CRNP-PMHNPI 1912678244
Title
Director
Phone
(718) 309-1190

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WH0200X RN202077 MD
Home Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WH0200X
Home Health Agency 251E00000X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

11405 Villa CT
Upper Marlboro, MD 20774-5702

Mailing address

11405 Villa CT
Upper Marlboro, MD 20774-5702
Phone (718) 309-1190

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220126000754 DC Part B Supplier - Clinic/Group Practice 8224420146 Receives reassigned benefits from 1 practitioner
Practice locations: Upper Marlboro, MD

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25683/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1380067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663545600000",
    "number": "1447686118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11405 VILLA CT",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207745702",
            "telephone_number": "718-309-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11405 VILLA CT",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207745702",
            "telephone_number": "718-309-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUGGERO HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-25",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A",
        "authorized_official_last_name": "OLUJOBI",
        "authorized_official_first_name": "BABATUNDE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "718-309-1190",
        "authorized_official_credential": "CRNP-PMH"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": "MD",
            "license": "RN202077",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.