Amy E Sucheski-Drake, MD

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

267020-1 Issued in NY

Practice address

110 Ho PLZ
Ithaca, NY 14853-3102

Phone

(607) 255-5155

NPI assigned

Nov 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Amy E Sucheski Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Cornell University

  • Student Health Clinic/Center
  • Ithaca, NY
  • NPI 1073584926
  NPD (past)
• Maine Medical Partners

  • Surgery Physician
  • Scarborough, ME
  • NPI 1346687167
  NPD (past)
• Mainehealth

  • Community/Retail Pharmacy
  • Portland, ME
  • NPI 1013868181
  NPD (past)

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1780752634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HO PLZ",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148533102",
            "telephone_number": "607-255-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HO PLZ",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148533102",
            "telephone_number": "607-255-5155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "96 Campus Dr",
            "address_2": "Suite 2C",
            "address_purpose": "LOCATION",
            "city": "Scarborough",
            "state": "ME",
            "postal_code": "04074",
            "country_code": "US",
            "telephone_number": "207-883-7926",
            "fax_number": "207-883-1925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUCHESKI-DRAKE",
        "first_name": "AMY",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NY",
            "license": "267020-1",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "ME",
            "license": "MD18314",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30209644",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "SUCHESKI",
            "middle_name": "E",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hunter Stuart
• Sandra K Studin, RN
• Ana Laura Suarez Gonzalez
• Kenneth Paul Subin, M.D.
• Gregory Subtelny
• Lindsey Suddaby
• Daniel Sudilovsky, MD
• Sharinne Sukhnanand, MSN, FNP-BC
• Diane Louise Sullivan
• Grant E Sullivan, RPH

• Sports Medicine (Family Medicine) Physician in Ithaca, NY
• Providers in Ithaca, NY by specialty
• Sports Medicine (Family Medicine) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.