Individual provider Active NPI

Susan Adydan

  • School Registered Nurse
  • Syracuse, NY
National Provider Identifier
1699052290
Registry record updated Nov 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
406607-1 Issued in NY
Practice address
400 Walberta Rd
Syracuse, NY 13219-2214
Phone
(315) 426-3203
NPI assigned
Nov 10, 2011
Last updated
Nov 10, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 406607-1 NY Primary

Addresses

Primary practice location

400 Walberta Rd
Syracuse, NY 13219-2214

Mailing address

400 Walberta Rd
Syracuse, NY 13219-2214

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

LicenseStateTypeSpecialty
406607-1NYMDSchool Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Westhill CSD Past Accepting new patients
Westhill Central School District Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1320883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1699052290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 WALBERTA RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132192214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 WALBERTA RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132192214",
            "telephone_number": "315-426-3203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADYDAN",
        "first_name": "SUSAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-10",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "406607-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.