Charmaine Mary Sulaica, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP128590 Issued in TX

Practice address

308 S Cesar Chavez Ave
Crystal City, TX 78839-4200

Phone

(830) 374-2301

Fax

(830) 374-9368

NPI assigned

Aug 12, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: charmaine.sulaica@vyshsi.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Vida Y Salud-Health Systems Inc

  • Federally Qualified Health Center (FQHC)
  • Crystal City, TX
  • NPI 1770511032
  Medicare reassignment

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

{
    "created_epoch": "1439337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1710353842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 S CESAR CHAVEZ AVE",
            "city": "CRYSTAL CITY",
            "state": "TX",
            "postal_code": "788394200",
            "telephone_number": "317-266-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 S CESAR CHAVEZ AVE",
            "city": "CRYSTAL CITY",
            "state": "TX",
            "postal_code": "788394200",
            "telephone_number": "830-374-2301",
            "fax_number": "830-374-9368"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6940 Michigan Rd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462682800",
            "country_code": "US",
            "telephone_number": "317-266-2901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULAICA",
        "first_name": "CHARMAINE",
        "middle_name": "MARY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-12",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "71007931A",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP128590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Elma Rivera, CNM, FNP
• Revae Rivera, ATC, LAT
• Andrea Ann Rodriguez, LPC
• Mirella Rodriguez, LVN
• Vivek Singh, DDS
• The Children's Clinic of Dimmit & Zavala
• Teresa Rios Valadez, FNP- BC
• Vida Adult Day Care
• Vida Nueva Adult Day Care
• Vida Y Salud Health Systems Inc

• Pediatric Nurse Practitioner in Crystal City, TX
• Providers in Crystal City, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.