Individual provider Active NPI

Seungmo Suh, MD

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1477015295
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
324760 Issued in NY
Practice address
121 Dekalb Ave
Brooklyn, NY 11201-5493
Phone
(718) 250-8000
NPI assigned
Apr 1, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 324760 NY Primary

Addresses

Primary practice location

121 Dekalb Ave
Brooklyn, NY 11201-5493

Mailing address

121 Dekalb Ave
Brooklyn, NY 11201-5493
Phone (718) 250-8000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230818001919 NY Practitioner - Internal Medicine 9638531858 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
324760NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Professional Services of Rhode Island Incorporated CurrentSince Aug 1, 2023 Accepting new patients
New York City Health and Hospitals Corporation Internal Medicine Past Accepting new patients

Locations

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

121 DeKalb Ave
Brooklyn, NY 11201
Phone (718) 250-6604

Networks

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

Interoperability endpoints

  • Direct secure messaging: ssuh17597@prd.direct.tbh.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1477015295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 DEKALB AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015493",
            "telephone_number": "718-250-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 DEKALB AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015493",
            "telephone_number": "718-250-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUH",
        "first_name": "SEUNGMO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-01",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "324760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.