Ye Su, DO

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

75478 Issued in CT

Practice address

80 S Main St Ste 101
Middletown, CT 06457-3648

Phone

(860) 358-5970

Fax

(860) 358-8690

NPI assigned

Mar 22, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Neurology

Education

Campbell Univ School of Osteopathic Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Middlesex HospitalGroup PAC ID 5092611731, 231 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Middlesex Hospital Hospital, Middletown, CT, CCN 070020

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkantawala89992@middlesexhealthprd.direct-ci.com

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.

• Middlesex Hospital

  • Family Nurse Practitioner
  • Middletown, CT
  • NPI 1972563138

  Neurology

  Medicare reassignment Care Compare group NPD
• Middlesex Hospital

  • Community Based Hospice Care Agency
  • Middletown, CT
  • NPI 1003873233
  NPD
• Middlesex Hospital

  • General Acute Care Hospital
  • Middletown, CT
  • NPI 1760454334
  NPD (past)

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

• Middlesex Hospital

  • General Acute Care Hospital
  • Middletown, CT
  • NPI 1760454334
  Care Compare affiliation

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1003376237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 CRESCENT ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573650",
            "telephone_number": "860-358-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 S MAIN ST STE 101",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573648",
            "telephone_number": "860-358-5970",
            "fax_number": "860-358-8690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 York St",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065103220",
            "country_code": "US",
            "telephone_number": "203-688-4242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SU",
        "first_name": "YE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-22",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CT",
            "license": "75478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mallory Streat
• Strength LLC
• Strong Minds, LLC
• Marilynn Rae Stuart, MD
• Tami C Stuckey, N/A
• Natalie Elizabeth Subbloie, RN
• Mandy Sullivan, LPC
• Olivia Sullivan
• Rylan Sullivan, LMSW
• Shawn Christopher Sullivan, PT

• Neurology Physician in Middletown, CT
• Providers in Middletown, CT by specialty
• Neurology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.