Individual provider Active NPI

Suzan Shifteh, PA

  • Surgical Physician Assistant
  • Great Neck, NY
National Provider Identifier
1295063246
Registry record updated Dec 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
005457 Issued in NY
Practice address
15 Barstow Rd
Great Neck, NY 11021-2229
Phone
(516) 482-8008
NPI assigned
Dec 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 005457 NY Primary

Addresses

Primary practice location

15 Barstow Rd
Great Neck, NY 11021-2229

Mailing address

15 Barstow Rd
Great Neck, NY 11021-2229

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
I20101206001041 NY Practitioner - Physician Assistant 7719174523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

300 Community Dr
Manhasset, NY 11030-3816

300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229

330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550

350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845

888 Old Country Rd
Plainview, NY 11803-4914
Phone (516) 719-3000

Hospital & facility affiliations

  • Plainview Hospital Hospital, Plainview, NY, CCN 330331

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
005457NYMDSurgical Physician Assistant

Networks

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

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1259798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259798400000",
    "number": "1295063246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 BARSTOW RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 BARSTOW RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212229",
            "telephone_number": "516-482-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIFTEH",
        "first_name": "SUZAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-03",
        "last_updated": "2009-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "005457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

Verify at the official NPI Registry.