Susan M Averso, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

F381569-1 Issued in NY

Practice address

35 Longwood Rd
Middle Island, NY 11953-2045

Phone

(631) 924-1000

Fax

(631) 924-1243

NPI assigned

Sep 13, 2011

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21444/brand/1/csg/1/fhir/r4

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.

• Just Kids Diagnostic and Treatment Center Inc

  • Clinic/Center
  • Middle Island, NY
  • NPI 1265570493
  NPD (past)

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315872000000",
    "number": "1619259942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12",
            "city": "MIDDLE ISLAND",
            "state": "NY",
            "postal_code": "119530012",
            "telephone_number": "631-924-1000",
            "fax_number": "631-924-1243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 LONGWOOD RD",
            "city": "MIDDLE ISLAND",
            "state": "NY",
            "postal_code": "119532045",
            "telephone_number": "631-924-1000",
            "fax_number": "631-924-1243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERSO",
        "first_name": "SUSAN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-13",
        "last_updated": "2011-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F381569-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Asciolla, MS
• Alicia Kathryn Astea
• Lee Ann Aug, MS
• Theresa Joan Augeri, R.N.
• Marielle Grace Austin, D.P.T.
• Kathryn Aviles
• Tanya E Ayala, LPN
• Jean Philippe Azor, LPN
• Alysondra Robinson Bacarella
• Bianca Bachisin

• Pediatric Nurse Practitioner in Middle Island, NY
• Providers in Middle Island, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.