Individual provider Active NPI

Suzanne Jordan, DPT

  • Physical Therapist
  • New York, NY
National Provider Identifier
1154624641
Registry record updated Dec 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
033287 Issued in NY
Practice address
115TH E 57TH St
#1460
New York, NY 10022-2077
Phone
(212) 486-0888
NPI assigned
Dec 6, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 033287 NY Primary

Addresses

Primary practice location

115TH E 57TH St
#1460
New York, NY 10022-2077

Mailing address

55 W 111TH St
5W
New York, NY 10026-4341
Phone (917) 539-4191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180514001273 NY Practitioner - Physical Therapist in Private Practice 9436413770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fox Rehabilitation Physical Therapy Services LLCGroup PAC ID 1355395179, 226 clinicians

Practice addresses (Care Compare)

1844 2ND Ave
New York, NY 10128-3862
Phone (877) 407-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
033287NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Physical Therapy Services LLC Physical Therapist CurrentSince May 21, 2018 Accepting new patients
P.T. and Pilates Inc. Past Accepting new patients
Midtown East Family Medicine PLLC PastSince Apr 11, 2016 Accepting new patients

Locations

7 Carnegie Plz
Cherry Hill, NJ 08003

1415 Richmond Ave
Staten Island, NY 10314
Phone (212) 475-5540

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1291593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293667200000",
    "number": "1154624641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 W 111TH ST",
            "address_2": "5W",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100264341",
            "telephone_number": "917-539-4191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115TH E 57TH ST",
            "address_2": "#1460",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100222077",
            "telephone_number": "212-486-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "SUZANNE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-06",
        "last_updated": "2010-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "033287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.