Susan Phelan, PH D NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

F4001481 Issued in NY

Practice address

251 E Oakland Ave Ste 2a
Port Jefferson, NY 11777-2602

Phone

(631) 760-1830

Fax

(631) 509-6080

NPI assigned

Jan 3, 2007

Sex

Female

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

State University of New York at Stony Brook, School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Dr. Gabrielle McAndrews, Psy.D., PC

  • Community/Behavioral Health Agency
  • Port Jefferson, NY
  • NPI 1144629585
  NPD (past)
• Rena Ferguson, MD, PC

  • Psychiatry Physician
  • Setauket, NY
  • NPI 1477703924
  NPD (past)
• Robert M Woznicki MD PC

  • Psychiatry Physician
  • Port Jefferson, NY
  • NPI 1285813667
  NPD (past)

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771200000000",
    "number": "1487711636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 E OAKLAND AVE STE 2A",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772602",
            "telephone_number": "631-760-1830",
            "fax_number": "631-509-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 E OAKLAND AVE STE 2A",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772602",
            "telephone_number": "631-760-1830",
            "fax_number": "631-509-6080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELAN",
        "first_name": "SUSAN",
        "credential": "PH D NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F4001481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01570447",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• George C Petro, MD
• Darlene Renee Petroccione, RD, CDN
• Susan Lucy Petroski
• Kimberly Pettis, M.S.CCC-SLP
• Danielle Peyman, AUD
• Christine Marie Piazza, OTR/L
• Claudette Steele Pike, R.N.
• Carl L Pillitteri, M.D.
• Joseph Pinkhas
• Ann Michelle Pinnata, MS RD

• Nurse Practitioner in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2026; 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.

Verify at the official NPI Registry.