Individual provider Active NPI

Susan Sherman-Tanzer

  • Specialist
  • Bayside, NY
National Provider Identifier
1376091439
Registry record updated Sep 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
189274871 Issued in NY
Practice address
20814 26TH Ave
Bayside, NY 11360-2460
Phone
(516) 551-4947
NPI assigned
Sep 19, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 189274871 NY Primary

Addresses

Primary practice location

20814 26TH Ave
Bayside, NY 11360-2460

Mailing address

20814 26TH Ave
Bayside, NY 11360-2460
Phone (516) 551-4947

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
189274871NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1474243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474243200000",
    "number": "1376091439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20814 26TH AVE",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113602460",
            "telephone_number": "516-551-4947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20814 26TH AVE",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113602460",
            "telephone_number": "516-551-4947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERMAN-TANZER",
        "first_name": "SUSAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-19",
        "last_updated": "2016-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "189274871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; 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.