Susan K Philip

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

013718 Issued in NY

Practice address

45 Little Clove Road
Staten Island, NY 10314

Phone

(718) 273-5522

NPI assigned

Apr 30, 2010

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Endo-Metabolic Practice PLLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Staten Island, NY
  • NPI 1932433364
  NPD (past)
• Icahn School of Medicine at Mount Sinai

  dba Icahn School of Medicine Pharmacy

  • Specialty Pharmacy
  • New York, NY
  • NPI 1629410816
  NPD (past)

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

{
    "created_epoch": "1272585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272585600000",
    "number": "1801113766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 WELLBROOK AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 LITTLE CLOVE ROAD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10314",
            "telephone_number": "718-273-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILIP",
        "first_name": "SUSAN",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-30",
        "last_updated": "2010-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "013718",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "013718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Phelps
• Kendra S. Phelps, LMSW
• Phildov Anesthesiology Group PC
• Annamma Philip, RN
• Jocelyn Philip, PA
• Christin Philipose
• Kunjumo Philipose
• Jacqueline S Phillip
• Liam Jamal Phillip, LPN
• Madeline Phillipps, LCSW

• Internal Medicine Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2010; 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.