Individual provider Active NPI

Susanne E. Cooperman, PHD

  • Clinical Psychologist
  • Huntington Station, NY
National Provider Identifier
1265496145
Registry record updated Mar 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
013809 Issued in NY
Practice address
180 E Pulaski Rd
Huntington Station, NY 11746-1915
Phone
(631) 425-2127
Fax
(631) 425-2238
NPI assigned
Apr 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 013809 NY Primary

Addresses

Primary practice location

180 E Pulaski Rd
Huntington Station, NY 11746-1915

Mailing address

180 E Pulaski Rd
Huntington Station, NY 11746-1915
Phone (631) 425-2127

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address scooperman104914@nyumc.direct-ci.com

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090629000414 NY Practitioner - Clinical Psychologist 5890846075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

180 E Pulaski Rd
Huntington Station, NY 11746-1915
Phone (516) 747-8900

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jun 1, 2015 Accepting new patients
New York University CurrentSince Jun 1, 2015 Accepting new patients

Locations

180 Pulaski Rd
Huntington Station, NY 11746
Phone (631) 425-2121

Networks

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615593600000",
    "number": "1265496145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 E PULASKI RD",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117461915",
            "telephone_number": "631-425-2127",
            "fax_number": "631-425-2238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 E PULASKI RD",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117461915",
            "telephone_number": "631-425-2127",
            "fax_number": "631-425-2238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPERMAN",
        "first_name": "SUSANNE",
        "middle_name": "E.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2021-03-13",
        "certification_date": "2021-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "013809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "scooperman104914@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "180 E Pulaski Rd",
            "city": "Huntington Station",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117461915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington Station, NY

Sources for this page

Verify at the official NPI Registry.