Individual provider Active NPI

Suzanne Soria, PA

  • Physician Assistant
  • Manchester, CT
National Provider Identifier
1548469497
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001912 Issued in CT
Practice address
192 E Center St
Manchester, CT 06040-5210
Phone
(860) 649-3243
Fax
(860) 649-5092
NPI assigned
Jul 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 001912 CT Primary
Internal Medicine Physician 207R00000X 001912 CT

Addresses

Primary practice location

192 E Center St
Manchester, CT 06040-5210

Mailing address

PO Box 3249
Vernon, CT 06066-2149
Phone (860) 896-1422

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ssoria58800@direct.med.uchc.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20080118000023 CT Practitioner - Physician Assistant 4688755481 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1912CTMDRegistered Dietitian
001912CTMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Starling Physicians PLLC CurrentSince Nov 1, 2020 Accepting new patients
Afc Physicians of Connecticut, PC CurrentSince Jun 26, 2020 Accepting new patients
Starling Physicians, PLLC Internal Medicine CurrentSince Nov 1, 2020 Accepting new patients
Afc Physicians of Connecticut, PC CurrentSince Jun 26, 2020 Accepting new patients

Locations

100 Simsbury Rd
Avon, CT 06001
Phone (860) 659-8830

2 Main St
Danbury, CT 06810
Phone (203) 826-2140

2110 Silas Deane Hwy
Rocky Hill, CT 06067

Organizations & group practices 6

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": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1548469497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3249",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060662149",
            "telephone_number": "860-896-1422",
            "fax_number": "860-896-1425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 E CENTER ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060405210",
            "telephone_number": "860-649-3243",
            "fax_number": "860-649-5092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORIA",
        "first_name": "SUZANNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2023-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "001912",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "001912",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ssoria58800@direct.med.uchc.edu",
            "affiliation": "N",
            "address_1": "Uconn Medical Group",
            "address_2": "263 Farmington Avenue",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060300001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.