Individual provider Active NPI

Militza E Suarez-Favetta, M.D.

  • Infectious Disease Physician
  • Tunkhannock, PA
National Provider Identifier
1477652196
Registry record updated Aug 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
MD041299E Issued in PA
Practice address
1 Kim Ave Ste 2
Tunkhannock, PA 18657-9101
Phone
(570) 996-6555
Fax
(570) 996-6557
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA05929800 NJ
Internal Medicine Physician 207R00000X MD041299E PA
Infectious Disease Physician 207RI0200X 25MA05929800 NJ
Infectious Disease Physician 207RI0200X MD041299E PA Primary

Addresses

Primary practice location

1 Kim Ave Ste 2
Tunkhannock, PA 18657-9101

Mailing address

330 Bowman St Unit 1
Wilkes Barre, PA 18702-5448
Phone (570) 823-5808

Other practice location 1

1710 E Broad St Ste A
Hazleton, PA 18201-5695
Phone (570) 459-6030

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address msuarez@wvacinc.org.nextgen.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20120104000295 PA Practitioner - Infectious DiseasePractitioner - Internal Medicine 4284798745 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wyoming Valley AIDS CouncilGroup PAC ID 8527398189, 2 clinicians

Practice addresses (Care Compare)

330 Bowman St
Unit 1
Wilkes Barre, PA 18702-5448
Phone (570) 823-5808

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA05929800NJMDInternal Medicine Physician
59298NJMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Oct 11, 2017 Accepting new patients
Wyoming Valley AIDS Council Infectious Disease CurrentSince Sep 10, 2019 Accepting new patients
Geisinger Clinic Current Accepting new patients
Intermountain Medical Group, Inc Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

426 Airport Rd
Ste 130
Hazle Township, PA 18202
Phone (570) 459-6030

1710 E Broad St
Ste A
Hazleton, PA 18201
Phone (570) 459-6030

1 Kim Ave
Ste 3
Tunkhannock, PA 18657
Phone (570) 996-6555

1 Kim Ave
Ste 2
Tunkhannock, PA 18657
Phone (570) 996-6555

250 Old River Rd
Ste C
Wilkes Barre, PA 18702
Phone (570) 826-5038

1000 E Mountain Dr
Wilkes Barre, PA 18711
Phone (570) 826-7300

330 Bowman St
Unit 1
Wilkes Barre, PA 18702
Phone (570) 823-5808

675 Baltimore Dr
Wilkes Barre, PA 18702
Phone (570) 808-5757

Interoperability endpoints

  • Direct secure messaging: militza.suarez-favetta@wvac-pa.direct.office.nextgen.com

Organizations & group practices 4

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1477652196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BOWMAN ST UNIT 1",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187025448",
            "telephone_number": "570-823-5808",
            "fax_number": "570-970-2725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KIM AVE STE 2",
            "city": "TUNKHANNOCK",
            "state": "PA",
            "postal_code": "186579101",
            "telephone_number": "570-996-6555",
            "fax_number": "570-996-6557"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1710 E Broad St Ste A",
            "address_purpose": "LOCATION",
            "city": "Hazleton",
            "state": "PA",
            "postal_code": "182015695",
            "country_code": "US",
            "telephone_number": "570-459-6030",
            "fax_number": "570-459-6206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUAREZ-FAVETTA",
        "first_name": "MILITZA",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA05929800",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD041299E",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NJ",
            "license": "25MA05929800",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "PA",
            "license": "MD041299E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msuarez@wvacinc.org.nextgen.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1 Kim Ave Ste 2",
            "city": "Tunkhannock",
            "state": "PA",
            "country_code": "US",
            "postal_code": "186579101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tunkhannock, PA

Sources for this page

Verify at the official NPI Registry.