Individual provider Active NPI

Susan L. Glodstein, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Huntington, NY
National Provider Identifier
1639328966
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F400335-1 Issued in NY
Practice address
17 E Carver St
Huntington, NY 11743-3409
Phone
(516) 581-1476
NPI assigned
Sep 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 406019-1 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 400335 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F400335-1 NY Primary

Addresses

Primary practice location

17 E Carver St
Huntington, NY 11743-3409

Mailing address

PO Box 745
Jericho, NY 11753-0745
Phone (516) 581-1476

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
I20120306000141 NY Practitioner - Nurse Practitioner 1456510825 Practice locations: Huntington, NY; Jericho, NY; Lake Ronkonkoma, NY

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

17 E Carver St
Huntington, NY 11743-3409
Phone (516) 581-1476

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
406019-1NYMDPsychiatric/Mental Health Registered Nurse
400335NYMDPsychiatric/Mental Health Nurse Practitioner
F400335-1NYMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1639328966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 745",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117530745",
            "telephone_number": "516-581-1476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 E CARVER ST",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117433409",
            "telephone_number": "516-581-1476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLODSTEIN",
        "first_name": "SUSAN",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-10",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NY",
            "license": "406019-1",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "400335",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F400335-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

Verify at the official NPI Registry.