Individual provider Active NPI

Sursattie Keso

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1740979814
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
351526 Issued in NY
Practice address
425 Westchester Ave
Bronx, NY 10455-1795
Phone
(718) 705-2555
NPI assigned
May 4, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 351526 NY Primary

Addresses

Primary practice location

425 Westchester Ave
Bronx, NY 10455-1795

Mailing address

2066 Blackrock Ave
Bronx, NY 10472-6104
Phone (929) 254-9751

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230608000529 NY Practitioner - Nurse Practitioner 6002273984 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Mercy College, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Century Medical and Dental Center IncGroup PAC ID 8729070669, 107 clinicians

Practice addresses (Care Compare)

2315 3Rd Ave
New York, NY 10035-1733
Phone (212) 540-5020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
351526NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Century Medical & Dental Center Inc CurrentSince May 1, 2025 Accepting new patients
Suny Downstate Medical Center Past Accepting new patients

Locations

425 Westchester Ave
Bronx, NY 10455
Phone (347) 343-0568

260 Avenue X
Brooklyn, NY 11223
Phone (718) 336-8855

2315 3rd Ave
New York, NY 10035
Phone (212) 369-5566

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1683158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1740979814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2066 BLACKROCK AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104726104",
            "telephone_number": "929-254-9751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 WESTCHESTER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104551795",
            "telephone_number": "718-705-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESO",
        "first_name": "SURSATTIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-04",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "351526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.