Suzanne Rudloff Brook, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1059504 Issued in NY

Practice address

28 Elm St
Huntington, NY 11743-3402

Phone

(631) 421-4398

NPI assigned

Oct 2, 2008

Last updated

Feb 7, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• Roger Koreen M.D., PC

  • Specialist
  • Huntington, NY
  • NPI 1649343914
  Medicare reassignment

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

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1699926147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 ELM ST",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117433402",
            "telephone_number": "631-421-4398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 ELM ST",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117433402",
            "telephone_number": "631-421-4398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOK",
        "first_name": "SUZANNE",
        "middle_name": "RUDLOFF",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-02",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "1059504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "1059504",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alan Brey, DPM PODIATRY
• Michael Alan Brickman, MD
• Bright Idea Counseling LLC
• Jessica Broder
• Kasey Brohan
• Elana Brooks, LMFT
• Jana L Brooks, PTA
• Michelle L Brosnan, MD
• Gregory Nathan Brown, CASAC
• Lucy Anne Brown, MBA, RD, CDN

• Physician Assistant in Huntington, NY
• Providers in Huntington, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2020; 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.