Individual provider Active NPI

Karine Lea Suskin, PSY.D.

  • Clinical Psychologist
  • Great Neck, NY
National Provider Identifier
1609875095
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
015163 Issued in NY
Practice address
29 Barstow Rd
Suite 205
Great Neck, NY 11021-2209
Phone
(516) 466-9726
Fax
(516) 466-1809
NPI assigned
Jul 18, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 015163 NY Primary

Addresses

Primary practice location

29 Barstow Rd
Suite 205
Great Neck, NY 11021-2209

Mailing address

29 Barstow Rd
Suite 205
Great Neck, NY 11021-2209
Phone (516) 466-9726

Other identifiers 1

IdentifierTypeStateIssuer
02383782MedicaidNY

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050412000861 NY Practitioner - Clinical Psychologist 3577500438 Practice locations: East Northport, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

11 E Haven LN
East Northport, NY 11731-6507
Phone (917) 992-5488

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
015163NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
R.P.P., Inc. Clinical Past Accepting new patients

Organizations & group practices 1

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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609875095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 BARSTOW RD",
            "address_2": "SUITE 205",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212209",
            "telephone_number": "516-466-9726",
            "fax_number": "516-466-1809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 BARSTOW RD",
            "address_2": "SUITE 205",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212209",
            "telephone_number": "516-466-9726",
            "fax_number": "516-466-1809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSKIN",
        "first_name": "KARINE",
        "middle_name": "LEA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "015163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02383782",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

Verify at the official NPI Registry.