Individual provider Active NPI

Suzanne Elizabeth McGlynn, N.P.

  • Pediatric Nurse Practitioner
  • Mount Vernon, NY
National Provider Identifier
1104268234
Registry record updated May 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
382435 Issued in NY
Practice address
8 Alameda PL
Mount Vernon, NY 10552-1201
Phone
(914) 260-9476
NPI assigned
Jul 17, 2013
Last updated
May 23, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 382435 NY Primary
Registered Nurse 163W00000X 658342 NY

Addresses

Primary practice location

8 Alameda PL
Mount Vernon, NY 10552-1201

Mailing address

8 Alameda PL
Mount Vernon, NY 10552-1201
Phone (914) 260-9476

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140813001864 NY Practitioner - Nurse Practitioner 3779700844 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
658342NYMDRegistered Nurse
382435NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Open Door Family Medical Center, Inc. CurrentSince Dec 9, 2022 Accepting new patients
Open Door Family Medical Center, Inc. Past Accepting new patients

Locations

165 Main St
Ossining, NY 10562
Phone (914) 941-1263

5 Grace Church St
Port Chester, NY 10573
Phone (914) 937-8899

Networks

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

Interoperability endpoints

  • Direct secure messaging: suzanne.mcglynn@odfmc.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400803200000",
    "number": "1104268234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 ALAMEDA PL",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105521201",
            "telephone_number": "914-260-9476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 ALAMEDA PL",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105521201",
            "telephone_number": "914-260-9476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGLYNN",
        "first_name": "SUZANNE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-17",
        "last_updated": "2014-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "382435",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "658342",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, NY

Sources for this page

Verify at the official NPI Registry.