Individual provider Active NPI

Mayra Alejandra Suarez, NP-BC, NP-C

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1932933769
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95029937 Issued in CA
Practice address
1550 Broadway Ste 2
San Diego, CA 92101-5713
Phone
(619) 515-2525
NPI assigned
Aug 26, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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 95029937 CA Primary

Addresses

Primary practice location

1550 Broadway Ste 2
San Diego, CA 92101-5713

Mailing address

823 Gateway Center Way
San Diego, CA 92102-4541
Phone (619) 515-2300

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
I20241021000660 CA Practitioner - Nurse Practitioner 2062944689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Health Centers of San Diego IncGroup PAC ID 3476446378, 299 clinicians

Practice addresses (Care Compare)

1809 National Ave
San Diego, CA 92113-2113
Phone (619) 515-2300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc. CurrentSince Oct 14, 2024 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Oct 14, 2024 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients

Locations

1550 Broadway
#2
San Diego, CA 92101
Phone (619) 515-2525

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1724630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1932933769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541",
            "telephone_number": "619-515-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 BROADWAY STE 2",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921015713",
            "telephone_number": "619-515-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUAREZ",
        "first_name": "MAYRA",
        "middle_name": "ALEJANDRA",
        "name_prefix": "Mrs.",
        "credential": "NP-BC, NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-26",
        "last_updated": "2024-10-14",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95029937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.