Individual provider Active NPI

Jane Suh, DO

  • Emergency Medicine Physician
  • Jbsa Lackland, TX
National Provider Identifier
1962089037
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MB12040600 Issued in NJ
Practice address
1100 Wilford Hall Loop
Jbsa Lackland, TX 78236-5638
Phone
(210) 292-4277
NPI assigned
Mar 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X V7073 TX
Emergency Medicine Physician 207P00000X 25MB12040600 NJ Primary

Addresses

Primary practice location

1100 Wilford Hall Loop
Jbsa Lackland, TX 78236-5638

Mailing address

1100 Wilford Hall Loop
Jbsa Lackland, TX 78236-5638

Other practice location 1

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Phone (210) 916-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20240216002119 NJ Practitioner - Emergency Medicine 5395189419

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
25MB12040600NJMDEmergency Medicine Physician
V7073TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inspira Health Network Medical Group, P.C. Past Accepting new patients

Organizations & group practices 1

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": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1962089037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "210-292-4277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3551 Roger Brooke Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Sam Houston",
            "state": "TX",
            "postal_code": "782344504",
            "country_code": "US",
            "telephone_number": "210-916-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUH",
        "first_name": "JANE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-25",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "V7073",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MB12040600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbsa Lackland, TX

Sources for this page

Verify at the official NPI Registry.