Mark Richard Sukoenig, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV003680 Issued in NY

Practice address

9537 Destinyusa Drive
Syracuse, NY 13204-9501

Phone

(315) 474-8490

Fax

(315) 474-8676

NPI assigned

Aug 23, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Luxottica of America Inc

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460592000000",
    "number": "1407848724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9537 DESTINYUSA DRIVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132049501",
            "telephone_number": "315-474-8490",
            "fax_number": "315-474-8676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9537 DESTINYUSA DRIVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132049501",
            "telephone_number": "315-474-8490",
            "fax_number": "315-474-8676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUKOENIG",
        "first_name": "MARK",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2016-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TU003680-1",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "NY",
            "license": "TU003680-1",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV003680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY OPTOMETRY LICENSE #",
            "identifier": "TU003680-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Genesis Sugrue
• Suhas V. Pradhan, M.D., P.C.
• Desiree M Suits, PA-C
• Leonard Suits Sr.
• Sukhreet Bibbs
• Amanda Sullivan
• Amanda Sullivan, M.S.
• Jeanne Theresa Sullivan, O.T.
• Joseph Charles Sullivan, MD
• Katherine Sullivan

• Optometrist in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.