Individual provider Active NPI

Susan Cardona, MD

  • Pediatrics Physician
  • Newburgh, NY
National Provider Identifier
1194775189
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
232920 Issued in NY
Practice address
355 Grand St
Newburgh, NY 12550-3613
Phone
(845) 616-0578
NPI assigned
May 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 232920 NY
Pediatrics Physician 208000000X 232920 NY Primary

Addresses

Primary practice location

355 Grand St
Newburgh, NY 12550-3613

Mailing address

355 Grand St
Newburgh, NY 12550-3613
Phone (845) 616-0578

Other identifiers 1

IdentifierTypeStateIssuer
02744443MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140311000792 NY Practitioner - Pediatric Medicine 1850307539 Reassigns benefits to 2 organizations
I20170417001267 TX Practitioner - Pediatric Medicine 1850307539 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
232920NYMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS,PHS,Naihs, Gallup Indian Medical Center CurrentSince Feb 28, 2017 Accepting new patients
Brookview Medical Associates, PLLC General Practice CurrentSince Nov 1, 2025 Accepting new patients
Boston Childrens Health Physicians LLP CurrentSince Aug 20, 2018 Accepting new patients
Boston Children'S Health Physicians, LLP Pediatrics CurrentSince Aug 20, 2018 Accepting new patients
Mid-Hudson Family Health Institute Pediatrics Past Accepting new patients

Locations

516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326

80 Orville Dr
Ste 100
Bohemia, NY 11716
Phone (516) 308-6610

19 Bradhurst Ave
Hawthorne, NY 10532
Phone (914) 493-7235

22 Saw Mill River Rd
Ste 2
Hawthorne, NY 10532
Phone (914) 593-1606

266 North St
Ste A
Newburgh, NY 12550
Phone (845) 565-5437

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1194775189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 GRAND ST",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125503613",
            "telephone_number": "845-616-0578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 GRAND ST",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125503613",
            "telephone_number": "845-616-0578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDONA",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "232920",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "232920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02744443",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, NY

Sources for this page

Verify at the official NPI Registry.