Carolann Sutherland, PA-C
Individual provider Active NPI Physician Assistant · West Islip, NY
NPI 1669943510 · NPPES record last updated Aug 13, 2024
Key facts
- NPI
- 1669943510
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 380 Montauk Hwy
West Islip, NY 11795-4403 - Phone
- (631) 422-5371
- NPI assigned
- Dec 17, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
- True North Medical of Suffolk PC
Practice addresses (Care Compare)
110 E Main St
Suite 2B
Huntington, NY 11743-2845
Phone (833) 774-6333
1175 Montauk Hwy
Suite 6
West Islip, NY 11795-4939
Phone (833) 774-6333
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250318002774 | NY | Practitioner - Physician Assistant | 1456873546 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | NY | Yes |
Addresses
Primary practice location
380 Montauk Hwy
West Islip, NY 11795-4403
Mailing address
380 Montauk Hwy
West Islip, NY 11795-4403
Phone (631) 422-5371
Other providers in West Islip, NY
- Frank Lincoln Sun
- Jeffrey Yading Sun
- Michelle A Sunshine
- Supersmiles Dental PLLC
- Supersmiles KDS Dental PC
- Tyler Francis Sutton
- SVC of West Islip, LLC
- Eileen Swailes
- Diane Marguerite Swezey
- Hasan Ahmed Syed
All providers in West Islip, NY · Physician Assistant in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.