Individual provider Active NPI

Suan J Valenzuela, AGNP

  • Adult Health Nurse Practitioner
  • Mohegan Lake, NY
National Provider Identifier
1639975014
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
312289 Issued in NY
Practice address
3550 Lexington Ave
Mohegan Lake, NY 10547-1273
Phone
(914) 528-2000
NPI assigned
Feb 24, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 312289 NY Primary

Addresses

Primary practice location

3550 Lexington Ave
Mohegan Lake, NY 10547-1273

Mailing address

3550 Lexington Ave
Mohegan Lake, NY 10547-1273
Phone (914) 528-2000

Other names 1

  • Mrs. Suan J Valenzuela Professional name

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

State licenses

LicenseStateTypeSpecialty
312289NYMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1740355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1639975014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 LEXINGTON AVE",
            "city": "MOHEGAN LAKE",
            "state": "NY",
            "postal_code": "105471273",
            "telephone_number": "914-528-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 LEXINGTON AVE",
            "city": "MOHEGAN LAKE",
            "state": "NY",
            "postal_code": "105471273",
            "telephone_number": "914-528-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENZUELA",
        "first_name": "SUAN",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-24",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "312289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUAN",
            "last_name": "VALENZUELA",
            "middle_name": "J",
            "prefix": "MRS.",
            "credential": "AGNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Mohegan Lake, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; 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.