Individual provider Active NPI

Sousan Numann

  • Pediatrics Physician
  • Howard Beach, NY
National Provider Identifier
1740340090
Registry record updated Jan 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
218338 Issued in NY
Practice address
15702 Crossbay Blvd
Howard Beach, NY 11414-2750
Phone
(718) 323-3591
NPI assigned
Dec 9, 2006
Last updated
Jan 18, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 218338 NY Primary

Addresses

Primary practice location

15702 Crossbay Blvd
Howard Beach, NY 11414-2750

Mailing address

80 Marcus Dr
Melville, NY 11747-4230
Phone (631) 391-7887

Other identifiers 1

IdentifierTypeStateIssuer
02194856MedicaidNY

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
I20200207000768 NY Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 0547457491

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
218338NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
TJH Medical Services, PC Past Accepting new patients
Galesburg Clinic PC 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": "1165622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358467200000",
    "number": "1740340090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 MARCUS DR",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474230",
            "telephone_number": "631-391-7887",
            "fax_number": "631-454-4163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15702 CROSSBAY BLVD",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114142750",
            "telephone_number": "718-323-3591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUMANN",
        "first_name": "SOUSAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-09",
        "last_updated": "2013-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "218338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02194856",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Howard Beach, NY

Sources for this page

Verify at the official NPI Registry.