Active NPI
Suzanne L. Polivy
- Midwife
- Brooklyn, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- F002170
- Practice address
- 4802 10TH Ave
Brooklyn, NY 11219-2916 - Phone
- (718) 283-6813
- NPI assigned
- Apr 21, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Midwife | 176B00000X | F002170 | NY | Primary |
Addresses
Primary practice location
4802 10TH Ave
Brooklyn, NY 11219-2916
Mailing address
967 48TH St
Brooklyn, NY 11219-2919
Phone (718) 283-6813
Other practice location 1
368 Fell St
San Francisco, CA 94102-5144
Phone (415) 861-0828
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F002170 | NY | MD | Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maimonides Medical Center MMC Midwifery | Midwife | Current | Accepting new patients |
| Maimonides Faculty Practice Plan | Current | Accepting new patients | |
| MMC OB-GYN Faculty Practice Plan | Current | Accepting new patients | |
| Planned Parenthood of the Columbia/Willamette, Inc. | Past | Accepting new patients |
Locations
967 48th St
Brooklyn, NY 11219
Phone (718) 283-8864
4508 16th Ave
Brooklyn, NY 11204
Phone (718) 972-8018
4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724
1616A Voorhies Ave
Brooklyn, NY 11235
Phone (718) 283-8225
6208 4th Ave
Brooklyn, NY 11220
Phone (718) 283-3000
Organizations & group practices 4
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.
-
- Internal Medicine Physician
- Brooklyn, NY
- NPI 1053344846
-
- Midwife
- Brooklyn, NY
- NPI 1548267750
-
- Specialist
- Brooklyn, NY
- NPI 1306843388
-
- Multi-Specialty Clinic/Center
- Portland, OR
- NPI 1053311860
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662422400000",
"number": "1710278072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "967 48TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112192919",
"telephone_number": "718-283-6813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4802 10TH AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112192916",
"telephone_number": "718-283-6813"
}
],
"practiceLocations": [
{
"address_1": "368 Fell St",
"address_purpose": "LOCATION",
"city": "San Francisco",
"state": "CA",
"postal_code": "941025144",
"country_code": "US",
"telephone_number": "415-861-0828",
"fax_number": "415-861-0257",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POLIVY",
"first_name": "SUZANNE",
"middle_name": "L.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-21",
"last_updated": "2022-09-06",
"certification_date": "2022-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "NY",
"license": "F002170",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; 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.