Individual provider Active NPI

Susan Koslowski, CRNP

  • Nurse Practitioner
  • Honesdale, PA
National Provider Identifier
1366812604
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP015287 Issued in PA
Practice address
1839 Fair Ave
Honesdale, PA 18431-2121
Phone
(570) 251-6500
NPI assigned
Sep 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP015287 PA Primary

Addresses

Primary practice location

1839 Fair Ave
Honesdale, PA 18431-2121

Mailing address

1839 Fair Ave
Honesdale, PA 18431-2121
Phone (570) 251-6500

Other names 1

  • Susan Tomaine Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, MT, IA, FL, NJ5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20161005002729 PA Practitioner - Nurse Practitioner 4981913605 Reassigns benefits to 2 organizations
I20220817000247 MT Practitioner - Nurse Practitioner 4981913605 Reassigns benefits to 1 organization
I20220913002370 IA Practitioner - Nurse Practitioner 4981913605 Reassigns benefits to 1 organization
I20221012001644 FL Practitioner - Nurse Practitioner 4981913605 Reassigns benefits to 1 organization
I20241104002047 NJ Practitioner - Nurse Practitioner 4981913605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ophelia Medical Group FL PAGroup PAC ID 7810398534, 103 clinicians
Ophelia Medical Group NJ PCGroup PAC ID 0547657397, 14 clinicians

Practice addresses (Care Compare)

Helena, MT 59601
Phone (215) 585-2144

161 Cecil B Moore Ave
Apt 204
Philadelphia, PA 19122-3243
Phone (215) 585-2144

2221 Brickyard Rd
Suite E
Adel, IA 50003-8300
Phone (215) 585-2144

230 US Hwy 206
Suite 4
Flanders, NJ 07836-9287
Phone (215) 585-2144

801 W Bay Dr
Suite 408
Largo, FL 33770-3220
Phone (215) 585-2144

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Pain Management Specialists, PC CurrentSince Jul 2, 2018 Accepting new patients
Ophelia Medical Group FL, P.a. CurrentSince Oct 5, 2021 Accepting new patients
Ophelia Medical Group, P.C. CurrentSince Oct 5, 2021 Accepting new patients
Ophelia Medical Group NJ PC CurrentSince Oct 15, 2024 Accepting new patients
Ophelia Medical Group Ny, P.C. PastSince Aug 1, 2022 Accepting new patients

Locations

801 West Bay Dr
Ste 408
Largo, FL 33770

2221 Brickyard Rd
Ste E
Adel, IA 50003

750 W Custer Ave
Ste 3
Helena, MT 59602

2 N Last Chance Gulch
Ste B
Helena, MT 59601

230 US Highway 206
Ste 4
Flanders, NJ 07836

228 Park Ave S
New York, NY 10003
Phone (215) 588-2144

11 Gallagher Dr
Wilkes Barre, PA 18705
Phone (570) 970-0259

Interoperability endpoints

  • Direct secure messaging: stomaine@apms.medentdirect.com
  • Direct secure messaging: susan.tomain@direct.wmchc.hie.keyhie.org

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": "1443484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1366812604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 FAIR AVE",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "184312121",
            "telephone_number": "570-251-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1839 FAIR AVE",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "184312121",
            "telephone_number": "570-251-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSLOWSKI",
        "first_name": "SUSAN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-29",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP015287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "TOMAINE",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Honesdale, PA

Sources for this page

Verify at the official NPI Registry.