Individual provider Active NPI

Omar F. Suarez, D.M.D.

  • Orofacial Pain Dentistry
  • New York, NY
National Provider Identifier
1891869814
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orofacial Pain DentistryTaxonomy code 1223X2210X
License
042834 Issued in NY
Practice address
800 2ND Ave RM 812
New York, NY 10017-9222
Phone
(973) 589-5900
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI01462000 NJ
General Practice Dentistry 1223G0001X 22DI01462000 NJ
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 042834 NY
Orofacial Pain Dentistry 1223X2210X 042834 NY Primary

Addresses

Primary practice location

800 2ND Ave RM 812
New York, NY 10017-9222

Mailing address

245 Wayne Ave
Cliffside Park, NJ 07010-2607
Phone (201) 264-0200

Other practice location 1

30 Ferry Street
Newark, NJ 07105
Phone (973) 589-5900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20050616000802 NJ Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 1658315973 Practice locations: Newark, NJ
I20170719002358 NY Practitioner - DentistPractitioner - Maxillofacial Surgery 1658315973 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
DentistAlso: Maxillofacial Surgery
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

850 2ND Ave
Suite 812
New York, NY 10017-2901
Phone (201) 264-0200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI01462000NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
NYU Langone Hospitals CurrentSince Jun 7, 2017 Accepting new patients
NYU Langone Hospitals CurrentSince Jun 7, 2017 Accepting new patients
NYU Langone Hospitals Current Accepting new patients
New York TMD Dentist CurrentSince Mar 1, 2023 Accepting new patients
North Bergen Dental Medicine Associates General Practice Past Accepting new patients

Locations

850 2nd Ave
Ste 812
New York, NY 10017
Phone (201) 264-0200

800 2nd Ave
Rm 812
New York, NY 10017
Phone (201) 264-0200

301 E 17th St
New York, NY 10003
Phone (212) 460-0125

305 2nd Ave
Ste 16
New York, NY 10003
Phone (212) 598-6091

Organizations & group practices 5

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1891869814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 WAYNE AVE",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070102607",
            "telephone_number": "201-264-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 2ND AVE RM 812",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100179222",
            "telephone_number": "973-589-5900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Ferry Street",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "07105",
            "country_code": "US",
            "telephone_number": "973-589-5900",
            "fax_number": "973-589-5969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUAREZ",
        "first_name": "OMAR",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI01462000",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI01462000",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "042834",
            "primary": false
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "NY",
            "license": "042834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.