Jaquelin Wallis Sugameli, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

0102208592 Issued in VA

Practice address

600 Gresham Dr
Norfolk, VA 23507-1904

Phone

(757) 388-3397

NPI assigned

Apr 8, 2021

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

Other names 1

• Jaquelin Wallis Johnson Former name

Medicare fee-for-service enrollment

Enrolled in VA

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 1

Specialty

Emergency Medicine

Education

Nova Southeastern College of Osteo Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Physicians of TidewaterGroup PAC ID 5092618462, 167 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sentara Obici Hospital Hospital, Suffolk, VA, CCN 490044
• Sentara Virginia Beach General Hospital Hospital, Virginia Beach, VA, CCN 490057
• Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119
• Sentara Leigh Hospital Hospital, Norfolk, VA, CCN 490046

Merit-based Incentive Payment System (MIPS)

Final score

97.87 of 100Reported as group

Quality

95.04

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Emergency Physicians of Tidewater

  • Emergency Medicine Physician
  • Norfolk, VA
  • NPI 1033136841
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sentara Hospitals

  • General Acute Care Hospital
  • Suffolk, VA
  • NPI 1376540138
  Care Compare affiliation
• Sentara Hospitals

  • General Acute Care Hospital
  • Virginia Beach, VA
  • NPI 1629038336
  Care Compare affiliation
• Sentara Hospitals

  • General Acute Care Hospital
  • Norfolk, VA
  • NPI 1811957681
  Care Compare affiliation
• Sentara Princess Anne Hospital

  • General Acute Care Hospital
  • Virginia Beach, VA
  • NPI 1528028396
  Care Compare affiliation

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1902486624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1980",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235011980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-388-3397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUGAMELI",
        "first_name": "JAQUELIN",
        "middle_name": "WALLIS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-08",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0102208592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAQUELIN",
            "last_name": "JOHNSON",
            "middle_name": "WALLIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Su McNeill, DMD, PLLC
• Valerie Angeli Suarez Santos, DMD
• Christine Ellen Subeh, RN, BSN
• Teresa Lynn Suciu, NP
• Jessica Suedbeck, RDH, MSDH
• Sugarland Healthcare
• Victoria Elizabeth Suggs, DPM
• Asna Sulaiman, MD
• Ayman Suliman
• Amber Sullivan, DO

• Emergency Medicine Physician in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Emergency Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.