Susanna Primakoff, RPA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

005715 Issued in NY

Practice address

95 Crystal Run Rd
Middletown, NY 10941-7001

Phone

(845) 703-6999

Fax

(845) 703-6297

NPI assigned

Oct 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sup9077@direct.nyp.org

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.

• Kingston Emergency Medical Associates PLLC

  • Emergency Medicine Physician
  • Kingston, NY
  • NPI 1891024303
  NPD (past)
• Atlantic Physician Services of Maryland, PC

  • Physician Assistant
  • Baltimore, MD
  • NPI 1174632376
  NPD (past)

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

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304467200000",
    "number": "1336338045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 CRYSTAL RUN RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414028",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 CRYSTAL RUN RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109417001",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIMAKOFF",
        "first_name": "SUSANNA",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-18",
        "last_updated": "2011-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "005715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01717500",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Prestige Pharmacy Inc (Prestige Pharmacy)
• Martin Preuss, PT
• Carline Preval
• Diana Previllon, DNP, FNP-C
• Giulia Preziuso, MHC
• Amy Katherine Prinzevalli, MS.ED.
• Linda Prioleau
• Amy E. Prisco-Ring, COTA/L
• Professional Obs-GYN of Orange Co LLP
• Marie D Prokopchak, PT

• Surgical Physician Assistant in Middletown, NY
• Providers in Middletown, NY by specialty
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.