Individual provider Active NPI

Nina Suda

  • Endocrinology, Diabetes & Metabolism Physician
  • Kinnelon, NJ
National Provider Identifier
1447646872
Registry record updated Jul 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
293447-01 Issued in NY
Practice address
170 Kinnelon Road Suite 28
Kinnelon, NJ 07405
Phone
(973) 838-1717
Fax
(973) 838-1775
NPI assigned
Apr 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 25MA11106600 NJ
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 293447-01 NY Primary
Internal Medicine Physician 207R00000X 25MA11106600 NJ

Addresses

Primary practice location

170 Kinnelon Road Suite 28
Kinnelon, NJ 07405

Mailing address

PO Box 95000 LB#7550
Philadelphia, PA 19195-7550
Phone (844) 362-1735

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200504001780 NY Practitioner - EndocrinologyPractitioner - Internal Medicine 7911243571 Reassigns benefits to 1 organization
I20210811003178 NJ Practitioner - EndocrinologyPractitioner - Internal Medicine 7911243571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Trustees of Columbia University in the City of New YorkGroup PAC ID 8527972546, 2,262 clinicians

Practice addresses (Care Compare)

622 W 168TH St
New York, NY 10032-3720
Phone (212) 305-9876

Hospital & facility affiliations

  • New York-Presbyterian Hospital Hospital, New York, NY, CCN 330101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
293447-01NYMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Partners, LLC Internal Medicine CurrentSince Oct 1, 2021 Accepting new patients
Trustees of Columbia University in the City of New York Internal Medicine CurrentSince Mar 1, 2020 Accepting new patients
Trustees of Columbia University in the City of New York Internal Medicine Current Accepting new patients
Trustees of Columbia University in the City of New York Internal Medicine CurrentSince Mar 1, 2020 Accepting new patients
Primary Care Partners, LLC Internal Medicine CurrentSince Oct 1, 2021 Accepting new patients
Trustees of Columbia University in the Department of Otolaryngology Past Accepting new patients

Locations

170 Kinnelon Rd
Rm 28
Kinnelon, NJ 07405
Phone (973) 838-1717

475 South St
Morristown, NJ 07960
Phone (973) 660-3166

465 South St
Ste 200
Morristown, NJ 07960
Phone (973) 971-7130

1150 Saint Nicholas Ave
Fl 2
New York, NY 10032
Phone (212) 851-5494

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

Networks

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

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 6

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1428883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720137600000",
    "number": "1447646872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95000 LB#7550",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191957550",
            "telephone_number": "844-362-1735",
            "fax_number": "973-290-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 KINNELON ROAD SUITE 28",
            "city": "KINNELON",
            "state": "NJ",
            "postal_code": "07405",
            "telephone_number": "973-838-1717",
            "fax_number": "973-838-1775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDA",
        "first_name": "NINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-13",
        "last_updated": "2024-07-05",
        "certification_date": "2024-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NJ",
            "license": "25MA11106600",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "293447-01",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA11106600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kinnelon, NJ

Sources for this page

Verify at the official NPI Registry.