Individual provider Active NPI

Susan Jormark, MD

  • Anatomic Pathology Physician
  • New York, NY
National Provider Identifier
1740252014
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
150000 Issued in NY
Practice address
100 E 77TH St
Suite 12
New York, NY 10021-1850
Phone
(212) 434-2361
Fax
(212) 434-4512
NPI assigned
Feb 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X 150000 NY Primary

Addresses

Primary practice location

100 E 77TH St
Suite 12
New York, NY 10021-1850

Mailing address

100 E 77TH St
Suite 12
New York, NY 10021-1850
Phone (212) 434-2361

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100826000641 NY Practitioner - Pathology 6507980638 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
150000NYMDAnatomic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Feb 1, 2014 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

1554 Northern Blvd
Manhasset, NY 11030
Phone (516) 390-9242

100 E 77th St
New York, NY 10075
Phone (212) 434-2606

100 E 77th St
Ste 12
New York, NY 10075
Phone (212) 434-2361

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1740252014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E 77TH ST",
            "address_2": "SUITE 12",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100211850",
            "telephone_number": "212-434-2361",
            "fax_number": "212-434-4512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E 77TH ST",
            "address_2": "SUITE 12",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100211850",
            "telephone_number": "212-434-2361",
            "fax_number": "212-434-4512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORMARK",
        "first_name": "SUSAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-02",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "NY",
            "license": "150000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.