Active NPI
Suzanne S. Borstein, PHD
- Clinical Psychologist
- Cranston, RI
National Provider Identifier
1457412629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS00522
- Practice address
- 75 Sockanosset Cross Road
Suite 212
Cranston, RI 02920-5558 - Phone
- (401) 941-2159
- Fax
- (401) 941-2159
- NPI assigned
- Dec 12, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS00522 | RI | Primary |
Addresses
Primary practice location
75 Sockanosset Cross Road
Suite 212
Cranston, RI 02920-5558
Mailing address
75 Sockanosset Cross Road
Suite 212
Cranston, RI 02920-5558
Phone (401) 941-2159
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9003397 | Medicaid | RI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 1, 2016 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334880000000",
"number": "1457412629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 SOCKANOSSET CROSS ROAD",
"address_2": "SUITE 212",
"city": "CRANSTON",
"state": "RI",
"postal_code": "029205558",
"telephone_number": "401-941-2159",
"fax_number": "401-941-2159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 SOCKANOSSET CROSS ROAD",
"address_2": "SUITE 212",
"city": "CRANSTON",
"state": "RI",
"postal_code": "029205558",
"telephone_number": "401-941-2159",
"fax_number": "401-941-2159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORSTEIN",
"first_name": "SUZANNE",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-12",
"last_updated": "2012-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "RI",
"license": "PS00522",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9003397",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cranston, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.