Individual provider Active NPI

Mary Suleiman, PA

  • Surgical Physician Assistant
  • Poughkeepsie, NY
National Provider Identifier
1316017767
Registry record updated Oct 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
009658 Issued in NY
Practice address
241 North Rd
Poughkeepsie, NY 12601-1154
Phone
(845) 483-5000
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 009658-1 NY
Surgical Physician Assistant 363AS0400X 009658 NY Primary

Addresses

Primary practice location

241 North Rd
Poughkeepsie, NY 12601-1154

Mailing address

19 Bradhurst Ave Ste 3100N
Hawthorne, NY 10532-2140
Phone (914) 909-9018

Other identifiers 1

IdentifierTypeStateIssuer
009658OtherNYNYS LICENSE

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
I20060504000410 NY Practitioner - Physician Assistant 7113937145 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

241 N Rd
Poughkeepsie, NY 12601-1154
Phone (845) 483-5000

45 Reade PL
Poughkeepsie, NY 12601-3947

95 Grasslands Rd
Valhalla, NY 10595-1652
Phone (914) 493-6940

Merit-based Incentive Payment System (MIPS)

Final score
81.38 of 100Reported as group
Quality
63.01
Promoting interoperability
98
Improvement activities
40
Cost
72.3

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
009658-1NYMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice PC Surgical CurrentSince May 24, 2010 Accepting new patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Jan 21, 2017 Accepting new patients
Saint Francis Hospital / Medicine Past Accepting new patients
Westchester Medical Center Past Accepting new patients

Locations

19 Bradhurst Ave
Ste 3100N
Hawthorne, NY 10532
Phone (914) 231-8373

1351 Route 55
Ste 200
Lagrangeville, NY 12540
Phone (845) 475-9622

45 Reade Pl
Fl 2
Poughkeepsie, NY 12601
Phone (845) 483-6001

241 North Rd
#3
Poughkeepsie, NY 12601
Phone (845) 431-8852

241 North Rd
Poughkeepsie, NY 12601
Phone (845) 431-8889

45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/0e5efebe-b60c-458e-971a-ee39e08a2178/

Organizations & group practices 5

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": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1316017767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BRADHURST AVE STE 3100N",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105322140",
            "telephone_number": "914-909-9018",
            "fax_number": "914-909-9028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 NORTH RD",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126011154",
            "telephone_number": "845-483-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULEIMAN",
        "first_name": "MARY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "009658-1",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "009658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "009658",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.