Peter Su, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

214785 Issued in NY

Practice address

250 Pettit Ave
Suite #1
Bellmore, NY 11710-3657

Phone

(516) 783-1577

Fax

(516) 783-1588

NPI assigned

Aug 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Brunswick Hospital Center, Inc

  • Psychiatric Hospital
  • Amityville, NY
  • NPI 1194748368
  NPD (past)
• RS Neuro Medical, P.C.

  • Specialist
  • Amityville, NY
  • NPI 1891815122
  NPD (past)
• South Shore Magnetic Resonance Imaging Associates PC

  dba Brunswick Medical Services PC

  • Specialist
  • Amityville, NY
  • NPI 1194736199
  NPD (past)

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225049414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 PETTIT AVE",
            "address_2": "SUITE #1",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "117103657",
            "telephone_number": "516-783-1577",
            "fax_number": "516-783-1588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 PETTIT AVE",
            "address_2": "SUITE #1",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "117103657",
            "telephone_number": "516-783-1577",
            "fax_number": "516-783-1588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SU",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "214785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02043456",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kylee Mae Stonebarger
• Tara Robyn Streeter
• Joanna M Strianese, SPECIAL EDUCATION TE
• Zackary Strunin
• Steven Jeffrey Stummer, D.P.M.
• Johanna Elizabeth Sullivan, MA CCC SLP
• Kristen Sundack
• Sunshine Acupunture PC
• Shelly Sweeney
• Shannon Taylor Szobesky

• Specialist in Bellmore, NY
• Providers in Bellmore, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.