Individual provider Active NPI

Susan Ina Kane, DO

  • Family Medicine Physician
  • Baldwin, NY
National Provider Identifier
1225204324
Registry record updated Feb 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
190439 Issued in NY
Practice address
2280 Grand Ave
Suite 208
Baldwin, NY 11510-3164
Phone
(516) 623-4800
Fax
(516) 378-1871
NPI assigned
May 8, 2008
Last updated
Feb 11, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 190439 NY Primary

Addresses

Primary practice location

2280 Grand Ave
Suite 208
Baldwin, NY 11510-3164

Mailing address

2280 Grand Ave
Suite 208
Baldwin, NY 11510-3164
Phone (516) 623-4800

Other names 1

  • Dr. Susan Ina Haber Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20040420001669 NY Practitioner - Family Practice 4688660335 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2280 Grand Ave
Suite 208
Baldwin, NY 11510-3110
Phone (516) 623-4800

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai School of Medicine CurrentSince Feb 1, 2019 Accepting new patients
Mount Sinai School of Medicine Current Accepting new patients
Mount Sinai School of Medicine Family Medicine CurrentSince Feb 1, 2019 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine Family Medicine Current Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine Family Medicine CurrentSince Jun 1, 2023 Accepting new patients

Locations

2280 Grand Ave
Ste 208
Baldwin, NY 11510
Phone (516) 623-4800

325 Park Ave
Huntington, NY 11743
Phone (631) 351-3700

775 Park Ave
Huntington, NY 11743
Phone (631) 396-1595

185 Merrick Rd
Lynbrook, NY 11563
Phone (516) 593-3535

1 Healthy Way
Oceanside, NY 11572
Phone (516) 255-1581

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455148800000",
    "number": "1225204324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2280 GRAND AVE",
            "address_2": "SUITE 208",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115103164",
            "telephone_number": "516-623-4800",
            "fax_number": "516-378-1871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2280 GRAND AVE",
            "address_2": "SUITE 208",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115103164",
            "telephone_number": "516-623-4800",
            "fax_number": "516-378-1871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANE",
        "first_name": "SUSAN",
        "middle_name": "INA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-08",
        "last_updated": "2016-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "190439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "HABER",
            "middle_name": "INA",
            "prefix": "DR.",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baldwin, NY

Sources for this page

Verify at the official NPI Registry.