Individual provider Active NPI

Susan A Baez, NPP

  • Psychiatric/Mental Health Nurse Practitioner
  • Kingston, NY
National Provider Identifier
1497713309
Registry record updated Jul 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F400833 Issued in NY
Practice address
105 Mary'S Avenue
Kingston, NY 12401
Phone
(845) 338-2500
Fax
(845) 334-3172
NPI assigned
May 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F400833 NY Primary

Addresses

Primary practice location

105 Mary'S Avenue
Kingston, NY 12401

Mailing address

185 Green Street
Ste 2
Kingston, NY 12401
Phone (845) 339-3736

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041207000593 NY Practitioner - Nurse Practitioner 6901862432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Spectrum Psychiatry, PCGroup PAC ID 9830367655, 9 clinicians

Practice addresses (Care Compare)

514 Haight Ave
Poughkeepsie, NY 12603-2464
Phone (845) 485-3506

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Psychiatry, PC CurrentSince Jun 1, 2012 Accepting new patients
Hudson Valley Psychiatric Associates LLC Past Accepting new patients

Locations

514 Haight Ave
Poughkeepsie, NY 12603
Phone (845) 485-3500

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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279756800000",
    "number": "1497713309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 GREEN STREET",
            "address_2": "STE 2",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "12401",
            "telephone_number": "845-339-3736",
            "fax_number": "845-339-6731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MARY'S AVENUE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "12401",
            "telephone_number": "845-338-2500",
            "fax_number": "845-334-3172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAEZ",
        "first_name": "SUSAN",
        "middle_name": "A",
        "credential": "NPP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2010-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F400833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.