Active NPI
Susan E Yurcisin, FNP
- Family Nurse Practitioner
- Mount Kisco, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F333154
- Practice address
- Mount Kisco Medical Group PC
90 South Bedford Road
Mount Kisco, NY 10549 - Phone
- (914) 241-1050
- Fax
- (914) 242-1516
- NPI assigned
- Jun 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F333154 | NY | Primary |
| Family Nurse Practitioner | 363LF0000X | 003475 | CT |
Addresses
Primary practice location
Mount Kisco Medical Group PC
90 South Bedford Road
Mount Kisco, NY 10549
Mailing address
Mount Kisco Medical Group PC
90 South Bedford Road
Mount Kisco, NY 10549
Phone (914) 241-1050
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02191862 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
101 Centerpoint Dr
Suite 215
Middletown, CT 06457-7568
Phone (888) 964-6681
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003475 | CT | MD | Speech-Language Pathologist |
| F333154 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthdrive Medical Services Southeast LLC | Family | Current | Accepting new patients |
| Value Based Long Term Care H PC | Current | Accepting new patients | |
| HDC Care Solutions, LLC | Family | Current | Accepting new patients |
| Careconnectmd Connecticut PC | Current | Accepting new patients | |
| NP Care, LLC | Past | Accepting new patients | |
| Absolute Outcomes, LLC | Past | Accepting new patients |
Locations
3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182
101 Centerpoint Dr
Ste 215
Middletown, CT 06457
Phone (203) 696-3550
5 Research Dr
Shelton, CT 06484
Phone (203) 567-5264
1266 E Main St
Stamford, CT 06902
Phone (203) 276-3000
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.
-
- Geriatric Medicine (Internal Medicine) Physician
- Stamford, CT
- NPI 1467187336
-
- Nurse Practitioner
- Columbia, MD
- NPI 1437930146
CT, Family
-
- Geriatric Medicine (Internal Medicine) Physician
- Framingham, MA
- NPI 1134951676
CT
-
- Internal Medicine Physician
- Monroe, CT
- NPI 1073746202
-
- Nurse Practitioner
- Shelton, CT
- NPI 1386693182
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185753600000",
"number": "1467491126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "MOUNT KISCO MEDICAL GROUP PC",
"address_2": "90 SOUTH BEDFORD ROAD",
"city": "MOUNT KISCO",
"state": "NY",
"postal_code": "10549",
"telephone_number": "914-241-1050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MOUNT KISCO MEDICAL GROUP PC",
"address_2": "90 SOUTH BEDFORD ROAD",
"city": "MOUNT KISCO",
"state": "NY",
"postal_code": "10549",
"telephone_number": "914-241-1050",
"fax_number": "914-242-1516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YURCISIN",
"first_name": "SUSAN",
"middle_name": "E",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-06",
"last_updated": "2007-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "F333154",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CT",
"license": "003475",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02191862",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mount Kisco, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2007; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.