Individual provider Active NPI

Susan E Suares, MSN

  • Family Nurse Practitioner
  • Folsom, CA
National Provider Identifier
1730304676
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP 12249 Issued in CA
Practice address
1600 Creekside Dr Ste 1200
Folsom, CA 95630-3445
Phone
(916) 932-4163
Fax
(916) 932-4167
NPI assigned
Apr 16, 2007
Last updated
Jan 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP 12249 CA Primary

Addresses

Primary practice location

1600 Creekside Dr Ste 1200
Folsom, CA 95630-3445

Mailing address

1600 Creekside Dr Ste 1200
Folsom, CA 95630-3445
Phone (916) 932-4163

Other identifiers 2

IdentifierTypeStateIssuer
P00442854OtherCARAILROAD
P00442854OtherCARAILROAD MEDICARE

Other names 1

  • Susan Eileen Suares Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20071130000304 CA Practitioner - Nurse Practitioner 2961591821 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
12249CAMDProfessional Counselor
NP 12249CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shingle Springs Rancheria CurrentSince Jun 13, 2022 Accepting new patients
Bingtao Lin, MD, PC CurrentSince Sep 26, 2022 Accepting new patients
Christopher Chen, M.D., Inc. PastSince Sep 26, 2022 Accepting new patients

Locations

1600 Creekside Dr
Ste 2400
Folsom, CA 95630
Phone (916) 932-4163

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1730304676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 CREEKSIDE DR STE 1200",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303445",
            "telephone_number": "916-932-4163",
            "fax_number": "916-932-4167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 CREEKSIDE DR STE 1200",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303445",
            "telephone_number": "916-932-4163",
            "fax_number": "916-932-4167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUARES",
        "first_name": "SUSAN",
        "middle_name": "E",
        "credential": "MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP 12249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00442854",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00442854",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "SUARES",
            "middle_name": "EILEEN",
            "credential": "FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Folsom, CA

Sources for this page

Verify at the official NPI Registry.