Nicole Surace, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

013555 Issued in NY

Practice address

159 W 1St St
Oswego, NY 13126-2045

Phone

(315) 349-5558

Fax

(315) 349-5652

NPI assigned

Oct 29, 2008

Sex

Female

Sole proprietor

No

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

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• State of New York Comptrollers Office

  • Developmental Disabilities Clinic/Center
  • Staten Island, NY
  • NPI 1750469912
  Medicare reassignment
• State of New York Comptrollers Office

  • Developmental Disabilities Clinic/Center
  • East Syracuse, NY
  • NPI 1114067915
  NPD

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

{
    "created_epoch": "1225238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225411200000",
    "number": "1205089620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 W 1ST ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262045",
            "telephone_number": "315-349-5558",
            "fax_number": "315-349-5652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 W 1ST ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131262045",
            "telephone_number": "315-349-5558",
            "fax_number": "315-349-5652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURACE",
        "first_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-29",
        "last_updated": "2008-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "013555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Beth Sullivan, MS ED, CCC-SLP
• Nicolette Sullivan, CTRS
• Sunrise Nursing Home Inc.
• Suny Oswego Walker Health Center
• Richard Suphan
• Jennifer Elizabeth Lola Swanson
• Maria Christine Sweeney
• Shelby T Sweeney, MS
• Jennifer M Szeluga
• Karen D Szewczyk, CNNP

• Occupational Therapist in Oswego, NY
• Providers in Oswego, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.