Individual provider Active NPI

Suzanne Marie Black, NP

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1235512468
Registry record updated Nov 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F340300 Issued in NY
Practice address
1120 Lexington Ave FL 2
New York, NY 10075-0309
Phone
(212) 434-4350
Fax
(212) 434-4408
NPI assigned
Jul 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F340300 NY Primary
Registered Nurse 163W00000X 686557 NY

Addresses

Primary practice location

1120 Lexington Ave FL 2
New York, NY 10075-0309

Mailing address

1120 Lexington Ave FL 2
New York, NY 10075-0309
Phone (212) 434-4350

Other identifiers 1

IdentifierTypeStateIssuer
00695941MedicaidNY

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160523001951 NY Practitioner - Nurse Practitioner 9638468192 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Weill Medical College of CornellGroup PAC ID 6800709023, shared by 46 NPIs, 2,023 clinicians

Practice addresses (Care Compare)

1305 York Ave
New York, NY 10021-5663

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
686557NYMDRegistered Nurse
F340300NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell Current Accepting new patients
Weill Medical College of Cornell CurrentSince Oct 23, 2024 Accepting new patients
Weill Medical College of Cornell CurrentSince Apr 11, 2025 Accepting new patients
North Shore-Lij Medical PC CurrentSince May 18, 2019 Accepting new patients
Weill Medical College of Cornell CurrentSince Oct 23, 2024 Accepting new patients
Weill Medical College of Cornell Current Accepting new patients

Locations

1305 York Ave
Fl 8
New York, NY 10021
Phone (646) 962-3176

1120 Lexington Ave
Fl 2
New York, NY 10075
Phone (212) 434-4350

1300 York Ave
New York, NY 10065
Phone (212) 746-2900

100 E 77th St
#2
New York, NY 10075
Phone (212) 434-2460

300 Community Dr
Plandome, NY 11030

Networks

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

Interoperability endpoints

  • Direct secure messaging: smb7001@direct.nyp.org
  • Direct secure messaging: suzanne.black@chn.eclinicaldirectplus.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541721600000",
    "number": "1235512468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 LEXINGTON AVE FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750309",
            "telephone_number": "212-434-4350",
            "fax_number": "212-434-4408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 LEXINGTON AVE FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750309",
            "telephone_number": "212-434-4350",
            "fax_number": "212-434-4408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "SUZANNE",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-07",
        "last_updated": "2018-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F340300",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "686557",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00695941",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.