Kevin Sustad

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

011247 Issued in NY

Practice address

2598 Orr St
Merrick, NY 11566-4744

Phone

(516) 941-7504

NPI assigned

Apr 8, 2021

Sex

Male

Sole proprietor

No

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sohomd.kevinsustad@157389.advancedmd-direct.com

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.

• Valera Medical, P.C.

  • Psychiatry Physician
  • Brooklyn, NY
  • NPI 1437782349

  Mental Health

  Medicare reassignment NPD

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1689254203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2598 ORR ST",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115664744",
            "telephone_number": "516-941-7504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2598 ORR ST",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115664744",
            "telephone_number": "516-941-7504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSTAD",
        "first_name": "KEVIN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-08",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "011247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Nicole Sullivan
• Summit Physical Therapy PC
• Sunrise Acupuncture Wellness
• Gail Sussman
• Shawn James Sussman
• Suydam Physical Therapy
• Michael J Suydam, PT
• Marissa S Sydial, PA-C
• Sadia Syed, MS, CCC-SLP
• Feliks Tabenshlak, M.S., CCC-SLP

• Mental Health Counselor in Merrick, NY
• Providers in Merrick, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.