Individual provider Active NPI

Suzanne Pavlou, M.D.

  • Pediatrics Physician
  • Jupiter, FL
National Provider Identifier
1669414355
Registry record updated Jan 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME 90011 Issued in FL
Practice address
1210 S. Old Dixie Hwy
Jupiter Medical Center
Jupiter, FL 33458
Phone
(561) 263-2234
NPI assigned
Jun 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME 90011 FL Primary
Pediatrics Physician 208000000X 01068644A IN
Pediatrics Physician 208000000X 25MA07348200 NJ

Addresses

Primary practice location

1210 S. Old Dixie Hwy
Jupiter Medical Center
Jupiter, FL 33458

Mailing address

1210 S Old Dixie Hwy
Jupiter Medical Center
Jupiter, FL 33458-7205
Phone (561) 263-2234

Other identifiers 1

IdentifierTypeStateIssuer
270305000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NJ, MI, GA4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20120629000274 FL Practitioner - Pediatric Medicine 4688838238 Reassigns benefits to 1 organization
I20170126002103 NJ Practitioner - Pediatric Medicine 4688838238 Reassigns benefits to 2 organizations
I20180220001971 MI Practitioner - Pediatric Medicine 4688838238 Reassigns benefits to 1 organization
I20230808002518 GA Practitioner - Pediatric Medicine 4688838238 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 90011FLMDPediatrics Physician
01068644AINMDPediatrics Physician
25MA07348200NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
W.a. Foote Memorial Hospital, Inc CurrentSince Jan 22, 2018 Accepting new patients
W. a. Foote Memorial Hospital, Inc. Current Accepting new patients
Baptist Physician Associates LLC Pediatrics CurrentSince Nov 1, 2015 Accepting new patients
Emergency Physician Services of New Jersey,Professional Association CurrentSince Dec 1, 2017 Accepting new patients
W.a. Foote Memorial Hospital, Inc Pediatrics CurrentSince Jan 22, 2018 Accepting new patients
Atlantic Emergency Physician Team Pediatric Associates, P.C. CurrentSince Dec 1, 2016 Accepting new patients
Cogent Healthcare of Georgia PC CurrentSince Jul 4, 2023 Accepting new patients
FL-I Medical Services, LLC Past Accepting new patients

Locations

1000 W Moreno St
Pensacola, FL 32501
Phone (850) 434-4011

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

1 Meadows Pkwy
Vidalia, GA 30474
Phone (912) 535-5429

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

760 W Franklin St
Jackson, MI 49201
Phone (517) 205-1461

718 Teaneck Rd
Teaneck, NJ 07666
Phone (201) 833-3232

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012
Phone (856) 513-4124

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

Interoperability endpoints

  • Direct secure messaging: spavlou51166@direct.nemours.org

Organizations & group practices 8

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452038400000",
    "number": "1669414355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 S OLD DIXIE HWY",
            "address_2": "JUPITER MEDICAL CENTER",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334587205",
            "telephone_number": "561-263-2234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 S. OLD DIXIE HWY",
            "address_2": "JUPITER MEDICAL CENTER",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "33458",
            "telephone_number": "561-263-2234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVLOU",
        "first_name": "SUZANNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2016-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME 90011",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01068644A",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA07348200",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270305000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

Verify at the official NPI Registry.