Individual provider Active NPI

Suzanne Lucido

  • Specialist
  • Englewood, NJ
National Provider Identifier
1548458144
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
010214-1 Issued in NY
Practice address
500 Grand Ave
1St Floor
Englewood, NJ 07631-4967
Phone
(201) 567-2277
Fax
(201) 567-2639
NPI assigned
Oct 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 010214-1 NY Primary

Addresses

Primary practice location

500 Grand Ave
1St Floor
Englewood, NJ 07631-4967

Mailing address

35 Germonds Rd
New City, NY 10956-2863
Phone (201) 567-2277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051020000860 NY Practitioner - Physical Therapist in Private Practice 3870519663 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Columbia University College of Physicians and Surgeons, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physical Medicine and Rehabilitation Center PAGroup PAC ID 1658273750, 26 clinicians

Practice addresses (Care Compare)

365 Route 304
Suite 102
Bardonia, NY 10954-1601
Phone (845) 624-2182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010214-1NYMDHome Health Agency

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Medicine and Rehabilitation Center PA CurrentSince Jan 1, 2005 Accepting new patients
We Care Physical Therapy, P.C. CurrentSince Nov 16, 2009 Accepting new patients
Columbia Doctors of New Jersey, P. C. Past Accepting new patients

Locations

500 Grand Ave
Ste 100
Englewood, NJ 07631
Phone (201) 227-1760

500 Grand Ave
Fl 1
Englewood, NJ 07631
Phone (201) 227-1760

365 Route 304
Ste 102
Nanuet, NY 10954
Phone (845) 624-2182

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 3

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": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1548458144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 GERMONDS RD",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109562863",
            "telephone_number": "201-567-2277",
            "fax_number": "201-567-2639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 GRAND AVE",
            "address_2": "1ST FLOOR",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314967",
            "telephone_number": "201-567-2277",
            "fax_number": "201-567-2639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCIDO",
        "first_name": "SUZANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-09",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "010214-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.