Titsania Elizabeth Supersad Coley, AGNP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

311883 Issued in NY

Practice address

25 Schoenfeld Blvd
Patchogue, NY 11772-2982

Phone

(631) 807-0085

NPI assigned

Jul 15, 2024

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

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

State licenses

Practice roles

Locations

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.

• NK Medical PC

  • Nephrology Physician
  • Shirley, NY
  • NPI 1467873018
  Medicare reassignment NPD
• Nsuh Plainview Physicians Ufp Corporation

  • Obstetrics & Gynecology Physician
  • New York, NY
  • NPI 1508750332
  Medicare reassignment NPD

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

{
    "created_epoch": "1721001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1700623907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "372 ISLIP AVE",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "117511808",
            "telephone_number": "631-277-8804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 SCHOENFELD BLVD",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117722982",
            "telephone_number": "631-807-0085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPERSAD COLEY",
        "first_name": "TITSANIA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-15",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "311883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suffolk Endodontics
• Stephanie Sujeski
• Katherine Beth Sullivan
• Sun River Health Inc
• Christina Marie Suozzo, NP
• SV OB/GYN, PC
• SV Pediatrics
• Fozia Syed, MD
• Sundas Tariq Syeda, PHYSCIAN ASSISTANT
• Natalie S Synnott, RN, NP

• Adult Health Nurse Practitioner in Patchogue, NY
• Providers in Patchogue, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; 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.