Individual provider Active NPI

Susan Paul, P.A.

  • Surgical Physician Assistant
  • Greenwich, CT
National Provider Identifier
1134556210
Registry record updated Oct 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
4224 Issued in CT
Practice address
6 Greenwich Office Park
Greenwich, CT 06831-5151
Phone
(203) 869-1145
Fax
(203) 618-1721
NPI assigned
Oct 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 4224 CT Primary

Addresses

Primary practice location

6 Greenwich Office Park
Greenwich, CT 06831-5151

Mailing address

6 Greenwich Office Park
Greenwich, CT 06831-5151
Phone (203) 869-1145

Other practice location 1

670 Stoneleigh Ave
Carmel, NY 10512-3997
Phone (845) 278-5687

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140226001879 NY Practitioner - Physician Assistant 3173753753 Reassigns benefits to 1 organization
I20181023001954 CT Practitioner - Physician Assistant 3173753753

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercy College, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

3400 Bainbridge Ave
Bronx, NY 10467-2404
Phone (914) 378-6148

Hospital & facility affiliations

  • Montefiore Medical Center Hospital, Bronx, NY, CCN 330059
  • Burke Rehabilitation Hospital Inpatient rehabilitation facility, White Plains, NY, CCN 333030

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
017089NYMDOccupational Therapist
4224CTMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Apr 12, 2019 Accepting new patients
Montefiore Medical Center CurrentSince Apr 12, 2019 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

1250 Waters Pl
Bronx, NY 10461
Phone (718) 409-9444

555 Taxter Rd
Elmsford, NY 10523
Phone (718) 920-2587

Networks

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

Interoperability endpoints

  • Direct secure messaging: supaul@montefioredirect.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1380758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538697600000",
    "number": "1134556210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 GREENWICH OFFICE PARK",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068315151",
            "telephone_number": "203-869-1145",
            "fax_number": "203-618-1721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 GREENWICH OFFICE PARK",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068315151",
            "telephone_number": "203-869-1145",
            "fax_number": "203-618-1721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "670 Stoneleigh Ave",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "NY",
            "postal_code": "105123997",
            "country_code": "US",
            "telephone_number": "845-278-5687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAUL",
        "first_name": "SUSAN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-03",
        "last_updated": "2018-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CT",
            "license": "4224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwich, CT

Sources for this page

Verify at the official NPI Registry.