Active NPI
Susan Cardona, MD
- Pediatrics Physician
- Newburgh, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 232920
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02744443 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 232920 | NY | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DHHS,PHS,Naihs, Gallup Indian Medical Center | Current | Accepting new patients | |
| Brookview Medical Associates, PLLC | General Practice | Current | Accepting new patients |
| Boston Childrens Health Physicians LLP | Current | Accepting new patients | |
| Boston Children'S Health Physicians, LLP | Pediatrics | Current | 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
- 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.
-
- Pediatrics Physician
- Hawthorne, NY
- NPI 1467454967
-
- General Practice Physician
- Bohemia, NY
- NPI 1871965855
-
- General Acute Care Hospital
- Gallup, NM
- NPI 1225002322
TX
-
- Clinical Medical Laboratory
- Sleepy Hollow, NY
- NPI 1588651079
-
- Family Medicine Physician
- New Paltz, NY
- NPI 1326093642
Pediatrics
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.