Matthew Sumicad

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

25MA11514700 Issued in NJ

Practice address

301 E Main St
Bay Shore, NY 11706-8408

Phone

(631) 968-3970

NPI assigned

Apr 22, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Practice roles

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.

• Valley Emergency Assoc PA

  • Emergency Medicine Physician
  • Paramus, NJ
  • NPI 1770532665
  Medicare reassignment NPD
• Barron Emergency Physicians LLC

  • Emergency Medicine Physician
  • Manahawkin, NJ
  • NPI 1790736940
  Medicare reassignment

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

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1194388512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068408",
            "telephone_number": "631-968-3970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMICAD",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-22",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA11514700",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Navindra Suknanan, BSN, RN, CWCN
• Kathleen M Sullivan-Murphy, CCC, SLP
• Jacqueline S Sullivan, P.A.
• Jadyn Elizabeth Sullivan, OTR/L
• Janine Sullivan, RN
• Sun Ray Super Drugs Inc.
• Sun Ray Super Drugs Inc.
• Sunrise Manor Nursing Home, Inc.
• Azhar Supariwala, M.D
• Ann Valerie Surpris

• Emergency Medicine Physician in Bay Shore, NY
• Providers in Bay Shore, NY by specialty
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; 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.