Colleen Stephanie Surlyn, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

270474-1 Issued in NY

Practice address

632 Broadway PH
New York, NY 10012-2614

Phone

(347) 933-6246

NPI assigned

Nov 24, 2009

Last updated

Oct 21, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Dr. Colleen Stephanie Lynch Other name

Medicare fee-for-service enrollment

Enrolled in CA, NY, SC, NM4 enrollments

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 4

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: colleen.surlyn@450368864321540.direct.elationemr.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Galileo Medical Group, NM PC

  • Family Medicine Physician
  • New York, NY
  • NPI 1548911746

  Internal Medicine, NM

  Medicare reassignment NPD
• Galileo Medical PC

  • Family Medicine Physician
  • New York, NY
  • NPI 1659853687

  Internal Medicine

  Medicare reassignment NPD
• Sun River Health Inc

  • Federally Qualified Health Center (FQHC)
  • Amenia, NY
  • NPI 1568526838
  Medicare reassignment NPD
• University of California SFGH Medical Group

  dba UCSF SFGH Medical Group Dept of Otolaryngology

  • Otolaryngology Physician
  • San Francisco, CA
  • NPI 1154396208
  Medicare reassignment NPD
• University of California SFGH Medical Group

  dba UCSF SFGH Medical Group Dept of Cardiology

  • Cardiovascular Disease Physician
  • San Francisco, CA
  • NPI 1386619344
  Medicare reassignment NPD
• Sun River Health Inc

  • Adult Day Care Clinic/Center
  • Bronx, NY
  • NPI 1740763275
  NPD
• Sun River Health Inc.

  • Federally Qualified Health Center (FQHC)
  • Peekskill, NY
  • NPI 1619969458
  NPD
• University of California SFGH Medical Group

  dba UCSF SFGH Medical Group Division of Vascular Surgery

  • Vascular Surgery Physician
  • San Francisco, CA
  • NPI 1033913959
  NPD
• University of California SFGH Medical Group

  dba UCSF SFGH Medical Group Dept of Medicine

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1306811930
  NPD
• Whitney M. Young Jr. Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Albany, NY
  • NPI 1942660105
  NPD (past)

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

{
    "created_epoch": "1259020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1053649418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 BLEECKER ST # 151",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100122410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 BROADWAY PH",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100122614",
            "telephone_number": "347-933-6246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 Lark Dr",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122071300",
            "country_code": "US",
            "telephone_number": "518-465-4771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SURLYN",
        "first_name": "COLLEEN",
        "middle_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-24",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "270474-1",
            "primary": true
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "NY",
            "license": "270474",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "LYNCH",
            "middle_name": "STEPHANIE",
            "prefix": "DR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Burton Surick, MD
• Gabrielle Surick
• Ana Suriel
• Carolyn Yelissa Suriel, RDH
• David Suriel, LCSW
• Ryan Surmay, P.A.
• Myrlandy Chrystel Surprise, MD
• Fouad Surur, MD
• Robert William Sury, M.D.
• Carter Suryadevara

• Internal Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; 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.

Verify at the official NPI Registry.