Individual provider Active NPI

Amanda I Sukhu, DO

  • Psychiatry Physician
  • Riverhead, NY
National Provider Identifier
1023538865
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
324130 Issued in NY
Practice address
905 E Main St
Riverhead, NY 11901-2613
Phone
(631) 632-2428
NPI assigned
Jun 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OT017943 PA
Psychiatry Physician 2084P0800X 324130 NY Primary

Addresses

Primary practice location

905 E Main St
Riverhead, NY 11901-2613

Mailing address

169 Putnam Hall Building C
Stony Brook, NY 11794-8515
Phone (631) 632-2428

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20230809003823 NY Practitioner - Psychiatry 5395107247 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-2990

169 Putnam Hall
South Campus
Stony Brook, NY 11794-8790
Phone (631) 632-8850

201 Manor PL
Greenport, NY 11944-1222
Phone (631) 477-1000

Lauterbur Dr
Stony Brook, NY 11794-0001
Phone (631) 638-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OT017943PAMDFamily Medicine Physician
324130NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Psychiatric Associates, University Faculty Practice Corpor Psychiatry CurrentSince Jul 1, 2023 Accepting new patients
Stony Brook Family and Preventive Medicine, University Faculty Practic Family Medicine PastSince Aug 6, 2023 Accepting new patients
University Hospital at Stony Brook PastSince Aug 6, 2023 Accepting new patients
University Hospital at Stony Brook Past Accepting new patients

Locations

169 Putnam Hall
Bldg C
Stony Brook, NY 11794

169 Putnam Hall
Stony Brook, NY 11794
Phone (631) 632-8850

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Organizations & group practices 4

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": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1023538865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 PUTNAM HALL BUILDING C",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948515",
            "telephone_number": "631-632-2428",
            "fax_number": "814-226-3478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 E MAIN ST",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012613",
            "telephone_number": "631-632-2428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUKHU",
        "first_name": "AMANDA",
        "middle_name": "I",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-22",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OT017943",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "324130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

Verify at the official NPI Registry.