Individual provider Active NPI

Sunoz Soroosh, CNM, WHNP-BC, MPH

  • Advanced Practice Midwife
  • New York, NY
National Provider Identifier
1265947840
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
F002169 Issued in NY
Practice address
462 1St Ave
New York, NY 10016-9196
Phone
(408) 656-3492
NPI assigned
Dec 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 671934 NY
Registered Nurse 163W00000X RN1063068 DC
Advanced Practice Midwife 367A00000X RN1063068 DC
Advanced Practice Midwife 367A00000X F002169 NY Primary

Addresses

Primary practice location

462 1St Ave
New York, NY 10016-9196

Mailing address

462 1St Ave
New York, NY 10016-9196
Phone (408) 656-3492

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
I20230413002147 NY Practitioner - Certified Nurse Midwife (CNM) 7517366099 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
671934NYMDRegistered Nurse
RN1063068DCMDAdvanced Practice Midwife
F002169NYMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Affiliate Group of New York PC CurrentSince Dec 9, 2024 Accepting new patients
Montefiore Medical Center CurrentSince Jan 10, 2025 Accepting new patients
North Shore - Lij Medical PC CurrentSince Mar 6, 2023 Accepting new patients
Montefiore Medical Center CurrentSince Jan 10, 2025 Accepting new patients
North Shore-Lij Medical PC CurrentSince Mar 6, 2023 Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients

Locations

3424 Kossuth Ave
Bronx, NY 10467
Phone (718) 519-3972

111 E 210th St
Bronx, NY 10467

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

225 E 64th St
Lowr
New York, NY 10065
Phone (646) 905-3900

300 Community Dr
Plandome, NY 11030

Networks

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

Interoperability endpoints

  • Direct secure messaging: sunozsoroosh@nslijmedgr.allscriptsdirect.net
  • Direct secure messaging: ssoroosh1168580@nychhc.direct-ci.com
  • Direct secure messaging: ssoroosh@montefioredirect.com
  • Direct secure messaging: ssoroosh24045@gwmfa.direct-ci.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": "1512432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1265947840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "462 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169196",
            "telephone_number": "408-656-3492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169196",
            "telephone_number": "408-656-3492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOROOSH",
        "first_name": "SUNOZ",
        "name_prefix": "Ms.",
        "credential": "CNM, WHNP-BC, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-05",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "671934",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DC",
            "license": "RN1063068",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "DC",
            "license": "RN1063068",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": "F002169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.