Kelsea Surace

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

094598 Issued in NY

Practice address

11 Farber Dr Ste D
Bellport, NY 11713-1500

Phone

(631) 286-0700

NPI assigned

Mar 7, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Brightside Medical, P.C.

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1508325184

  NY

  Medicare reassignment NPD

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

{
    "created_epoch": "1520380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1154823896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 MAPLE AVE",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117681937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 FARBER DR STE D",
            "city": "BELLPORT",
            "state": "NY",
            "postal_code": "117131500",
            "telephone_number": "631-286-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURACE",
        "first_name": "KELSEA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-07",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "094598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Stellakis
• Stephanie Columbia LCSW PC
• Ashley Ann Stock, LMHC
• Michael John Stuto, D.C.
• Suffolk County Dept of Health Services
• Rose Myrlene Surprise
• Aiman Syed
• Maryann Helen Tedesco-Miller, LCSW
• Santamaria Terzo
• TH Rehab Occupational Therapy Services, P.C.

• Clinical Social Worker in Bellport, NY
• Providers in Bellport, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; 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.