NPIMap

Individual provider Active NPI

Sherry K Sussman, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Smithtown, NY
National Provider Identifier
1235176280
Registry record updated Jun 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
205106 Issued in NY
Practice address
285 Middle Country Rd
Suite 105
Smithtown, NY 11787-2978
Phone
(631) 509-0390
Fax
(631) 656-0875
NPI assigned
May 31, 2006
Last updated
Jun 7, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 205106 NY Primary

Addresses

Primary practice location

285 Middle Country Rd
Suite 105
Smithtown, NY 11787-2978

Mailing address

285 Middle Country Rd
Suite 105
Smithtown, NY 11787-2978
Phone (631) 509-0390

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091022000351 NY Practitioner - Endocrinology 0446344758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
State University of New York at Stony Brook, School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Middle Country Endocrinology, PCGroup PAC ID 9032256169, 3 clinicians

Practice addresses (Care Compare)

285 E Main St
Suite 105
Smithtown, NY 11787-2912
Phone (631) 509-0390

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.22 of 100Reported as individual
Quality
89.95
Promoting interoperability
99
Improvement activities
40
Cost
74.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
205106NYMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Middle Country Endocrinology, PC Endocrinology, Diabetes & Metabolism CurrentSince Nov 1, 2009 Accepting new patients
Island Endocrinology,P.C. Endocrinology, Diabetes & Metabolism Past Accepting new patients

Locations

285 E Middle Country Rd
Ste 105
Smithtown, NY 11787
Phone (631) 509-0390

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CJCEAD

Organizations & group practices 2

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 10

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370563200000",
    "number": "1235176280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 MIDDLE COUNTRY RD",
            "address_2": "SUITE 105",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872978",
            "telephone_number": "631-509-0390",
            "fax_number": "631-656-0875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 MIDDLE COUNTRY RD",
            "address_2": "SUITE 105",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872978",
            "telephone_number": "631-509-0390",
            "fax_number": "631-656-0875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSSMAN",
        "first_name": "SHERRY",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2013-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "205106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

Verify at the official NPI Registry.