Louisette Lise Soussan, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

287524 Issued in NY

Practice address

1 Atwell Rd
Cooperstown, NY 13326-1301

Phone

(607) 547-7608

Fax

(607) 547-3259

NPI assigned

Mar 27, 2012

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

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

Specialty

NephrologyAlso: Internal Medicine

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Meeting House Lane Medical Practice PCGroup PAC ID 6800972589, 125 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722

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.

• Meeting House Lane Medical Practice PC

  • Internal Medicine Physician
  • Southampton, NY
  • NPI 1902088495
  Medicare reassignment Care Compare group NPD
• Mary Imogene Bassett Hospital

  • Multi-Specialty Clinic/Center
  • Cooperstown, NY
  • NPI 1083664221
  Medicare reassignment NPD
• Mary Imogene Bassett Hospital

  • Specialty Pharmacy
  • Oneonta, NY
  • NPI 1174419196
  NPD
• Stony Brook Internists, University Faculty Practice Corporation

  • Internal Medicine Physician
  • Stony Brook, NY
  • NPI 1821035601
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• University Hospital at Stony Brook

  • General Acute Care Hospital
  • Southampton, NY
  • NPI 1033224704
  Care Compare affiliation
• University Hospital at Stony Brook

  • General Acute Care Hospital
  • Southampton, NY
  • NPI 1225507114
  Care Compare affiliation
• University Hospital at Stony Brook

  • Land Ambulance
  • Stony Brook, NY
  • NPI 1306620588

  Hospital

  Care Compare affiliation
• University Hospital at Stony Brook

  • General Acute Care Hospital
  • Greenport, NY
  • NPI 1881690691
  Care Compare affiliation
• University Hospital at Stony Brook

  • Clinic/Center
  • Greenport, NY
  • NPI 1932466604

  Hospital

  Care Compare affiliation
• University Hospital at Stony Brook

  • General Acute Care Hospital
  • Stony Brook, NY
  • NPI 1972523348
  Care Compare affiliation

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

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508198400000",
    "number": "1811263569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133261301",
            "telephone_number": "607-547-7608",
            "fax_number": "607-547-3259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133261301",
            "telephone_number": "607-547-7608",
            "fax_number": "607-547-3259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUSSAN",
        "first_name": "LOUISETTE",
        "middle_name": "LISE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-27",
        "last_updated": "2017-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "287524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen E Smith, LMSW
• Stephanie Lynne Smith
• Rajat Soni
• James J Sonn, MD
• Rafferty Craig Sorensen, CRNA
• Stacia Southcott, RDN
• Lucas Spencer, RN
• Matthew W Spencer, M.D.
• Sunny John Cosmo Spinosa, DDS
• Nikita Srivalsan, M.D.

• Internal Medicine Physician in Cooperstown, NY
• Providers in Cooperstown, 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 Oct 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.