Robert R Surprenant, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

315 S Manning Blvd
7422 Gab Love
Albany, NY 12208-1707

Phone

(518) 525-1693

NPI assigned

May 5, 2009

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

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Sentara Medical Group

  • Family Medicine Physician
  • Norfolk, VA
  • NPI 1265485270
  Medicare reassignment NPD

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

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465257600000",
    "number": "1497989404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 GRESHAM DR",
            "address_2": "# 5B",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071904",
            "telephone_number": "757-388-3198",
            "fax_number": "757-388-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S MANNING BLVD",
            "address_2": "7422 GAB LOVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122081707",
            "telephone_number": "518-525-1693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURPRENANT",
        "first_name": "ROBERT",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-05",
        "last_updated": "2016-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arthur Lewis Sunkin, MD
• Maria Sunukjian, LCSWR
• Supply Solutions a Division of Northeast Mobility Center
• Selim Surer
• Shruthi Suresh, MD
• Brandi Surridge, LCSW
• Venkat Prahas Suru, DO
• Surya Physicals, PC
• Susan K Gibbons MD PLLC
• Susan M Austin MD PLLC

• Surgical Physician Assistant in Albany, NY
• Providers in Albany, NY by specialty
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; 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.