Individual provider Active NPI

Suman P Johnson, PHYSICIAN ASSITANT

  • Medical Physician Assistant
  • Mineola, NY
National Provider Identifier
1295080778
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
015591-1 Issued in NY
Practice address
259 1St St
Mineola, NY 11501-3957
Phone
(516) 663-8312
NPI assigned
Jul 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 015591-1 NY Primary

Addresses

Primary practice location

259 1St St
Mineola, NY 11501-3957

Mailing address

27005 76TH Ave
New Hyde Park, NY 11040-1402
Phone (516) 470-7000

Other practice location 1

27005 76th Ave
New Hyde Park, NY 11040-1402
Phone (516) 470-7000

Other names 1

  • Suman P Thomas Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sjohnson307487@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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130730000070 NY Practitioner - Physician Assistant 0749421030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
015591-1NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jun 30, 2019 Accepting new patients
New York University CurrentSince Jun 30, 2019 Accepting new patients

Locations

259 1st St
Mineola, NY 11501
Phone (516) 576-1820

27005 76th Ave
North New Hyde Pk, NY 11040

300 Community Dr
Plandome, NY 11030

Networks

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

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": "1342656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1295080778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27005 76TH AVE",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110401402",
            "telephone_number": "516-470-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 1ST ST",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013957",
            "telephone_number": "516-663-8312"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27005 76th Ave",
            "address_purpose": "LOCATION",
            "city": "New Hyde Park",
            "state": "NY",
            "postal_code": "110401402",
            "country_code": "US",
            "telephone_number": "516-470-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SUMAN",
        "middle_name": "P",
        "name_prefix": "Mrs.",
        "credential": "PHYSICIAN ASSITANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-19",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "015591-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjohnson307487@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "259 1st St",
            "city": "Mineola",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115013957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SUMAN",
            "last_name": "THOMAS",
            "middle_name": "P",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.