Suranganee Mary De Lanerolle, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

152287 Issued in NY

Practice address

2500 Nesconset Highway
Stonybrook Medical Park BLDG 16a
Stonybrook, NY 11790

Phone

(631) 246-5454

Fax

(631) 246-5902

NPI assigned

Oct 20, 2006

Last updated

Nov 8, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Suffolk Neurology & Neurophysiology PC

  • Neurology Physician
  • Stony Brook, NY
  • NPI 1033362884
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541635200000",
    "number": "1144302977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NESCONSET HWY",
            "address_2": "BLDG 12B",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902553",
            "telephone_number": "631-246-5454",
            "fax_number": "631-246-5902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NESCONSET HIGHWAY",
            "address_2": "STONYBROOK MEDICAL PARK BLDG 16A",
            "city": "STONYBROOK",
            "state": "NY",
            "postal_code": "11790",
            "telephone_number": "631-246-5454",
            "fax_number": "631-246-5902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LANEROLLE",
        "first_name": "SURANGANEE",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2018-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "152287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "CS733",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00894654",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "130015641",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDNY",
            "identifier": "AH46028",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "107738500",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4318339",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WC",
            "identifier": "CPNN",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WC",
            "identifier": "M1522879",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mohsen Davoudi, MD
• Sharline Dawes, P.A.
• Timothy Jeffrey Daws
• James De Jesus, REGISTERED NURSE
• Katherine Anne De Jesus, PHARMD
• Sasrika De Silva, DO
• Jonathan Austin Deassis, MD
• Sara Deboer
• Angela Debrodt, MS, RN, AGNP-C
• Bernadette C. Decarlo, AGPCNP-BC

• Neurology Physician in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Neurology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2018; 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.