Individual provider Active NPI

Suzette Catherine Smookler, M.S., R.D., CDN

  • Registered Dietitian
  • Stony Brook, NY
National Provider Identifier
1073837175
Registry record updated Mar 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
000775 Issued in NY
Practice address
Stony Brook University Hospital
Nicolls Road, Level 1 RM 747
Stony Brook, NY 11794-0001
Phone
(631) 444-7757
Fax
(631) 632-2587
NPI assigned
Mar 17, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 000775 NY Primary

Addresses

Primary practice location

Stony Brook University Hospital
Nicolls Road, Level 1 RM 747
Stony Brook, NY 11794-0001

Mailing address

Stony Brook University Hospital
Nicolls Road, Level 1 RM 747
Stony Brook, NY 11794-0001
Phone (631) 444-7757

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
000775NYMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1268784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268784000000",
    "number": "1073837175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "STONY BROOK UNIVERSITY HOSPITAL",
            "address_2": "NICOLLS ROAD, LEVEL 1 RM 747",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-444-7757",
            "fax_number": "631-632-2587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STONY BROOK UNIVERSITY HOSPITAL",
            "address_2": "NICOLLS ROAD, LEVEL 1 RM 747",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-444-7757",
            "fax_number": "631-632-2587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOOKLER",
        "first_name": "SUZETTE",
        "middle_name": "CATHERINE",
        "name_prefix": "Mrs.",
        "credential": "M.S., R.D., CDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-17",
        "last_updated": "2010-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "000775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.