Derek Hudson Suite, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

198909-1 Issued in NY

Practice address

1136 Neill Ave
Bronx, NY 10461-1328

Phone

(718) 518-7600

Fax

(718) 518-7647

NPI assigned

Nov 11, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Full Circle Health, PLLC

  • Psychiatry Physician
  • Bronx, NY
  • NPI 1952595050
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432684800000",
    "number": "1467433862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1136 NEILL AVENUE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612801",
            "telephone_number": "718-518-7600",
            "fax_number": "718-518-7647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 NEILL AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611328",
            "telephone_number": "718-518-7600",
            "fax_number": "718-518-7647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUITE",
        "first_name": "DEREK",
        "middle_name": "HUDSON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-11",
        "last_updated": "2015-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "198909-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02501820",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marie Joyce Suh, P.T.
• Won H Suh, RPH
• Yon Jung Suh
• Yoo Mi Suh, NP
• Mark J Suhrland, MD
• Mikhail Sukhoroslov, MD
• Donjeta Sulaj, MD
• Muhammed Mutari Sule-Jawando
• Resmi Sulekha, M.D
• Natasha Suleman, M.D.

• Psychiatry Physician in Bronx, NY
• Providers in Bronx, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.