Active NPI
Suzanne Spellman
- School Psychologist
- Bronx, NY
National Provider Identifier
1669014239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 231636
- Practice address
- 5400 Fieldston Rd Apt 21C
Bronx, NY 10471-2593 - Phone
- (917) 902-0279
- NPI assigned
- Oct 15, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | |||
| School Psychologist | 103TS0200X | 231636 | NY | Primary |
Addresses
Primary practice location
5400 Fieldston Rd Apt 21C
Bronx, NY 10471-2593
Mailing address
5400 Fieldston Rd Apt 21C
Bronx, NY 10471-2593
Phone (917) 902-0279
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 231636 | NY | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662940800000",
"number": "1669014239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5400 FIELDSTON RD APT 21C",
"city": "BRONX",
"state": "NY",
"postal_code": "104712593",
"telephone_number": "917-902-0279"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5400 FIELDSTON RD APT 21C",
"city": "BRONX",
"state": "NY",
"postal_code": "104712593",
"telephone_number": "917-902-0279"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPELLMAN",
"first_name": "SUZANNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-15",
"last_updated": "2022-09-12",
"certification_date": "2022-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "NY",
"license": "231636",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.