Active NPI
Susan Spadafora, N.P.
- Pediatric Nurse Practitioner
- Bronx, NY
National Provider Identifier
1043389455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 380518
- Practice address
- 3424 Kossuth Ave
Bronx, NY 10467-2410 - Phone
- (718) 519-3015
- NPI assigned
- Nov 7, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 380518 | NY | Primary |
Addresses
Primary practice location
3424 Kossuth Ave
Bronx, NY 10467-2410
Mailing address
91 Payson Ave
Apt#6D
New York, NY 10034-2722
Phone (212) 304-8875
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ | Health Information Exchange (HIE) | |
| FHIR URL | https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) | |
| Direct Messaging Address | tho9026@direct.nyp.orp | Direct |
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: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 380518 | NY | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kings Physician Services, PC | Current | Accepting new patients | |
| Kings Physician Services, PC | Current | Accepting new patients | |
| PM Pediatrics of Mamaroneck | Past | Accepting new patients | |
| PM Pediatrics PC | Past | Accepting new patients |
Locations
506 6th St
Brooklyn, NY 11215
Phone (718) 780-3279
506 6th St
Ste B
Brooklyn, NY 11215
Phone (718) 780-3677
2649 Strang Blvd
Ste 304
Yorktown Heights, NY 10598
Phone (646) 745-6369
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- 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.
-
- Diagnostic Radiology Physician
- Brooklyn, NY
- NPI 1083045090
-
- Emergency Medicine Physician
- Brooklyn, NY
- NPI 1326698879
-
- Urgent Care Clinic/Center
- Mamaroneck, NY
- NPI 1073645180
-
- Urgent Care Clinic/Center
- Syosset, NY
- NPI 1730212390
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732147200000",
"number": "1043389455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "91 PAYSON AVE",
"address_2": "APT#6D",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100342722",
"telephone_number": "212-304-8875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3424 KOSSUTH AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104672410",
"telephone_number": "718-519-3015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPADAFORA",
"first_name": "SUSAN",
"name_prefix": "Ms.",
"credential": "N.P.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-07",
"last_updated": "2024-11-21",
"certification_date": "2024-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "NY",
"license": "380518",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
"affiliation": "N",
"endpointDescription": "FHIR",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "FHIR",
"address_1": "506 6th St",
"city": "Brooklyn",
"state": "NY",
"country_code": "US",
"postal_code": "112153609",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "FHIR",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "FHIR",
"address_1": "506 6th St",
"city": "Brooklyn",
"state": "NY",
"country_code": "US",
"postal_code": "112153609",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tho9026@direct.nyp.orp",
"affiliation": "N",
"endpointDescription": "Direct Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Direct Address",
"address_1": "506 6th St",
"city": "Brooklyn",
"state": "NY",
"country_code": "US",
"postal_code": "112153609",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.