Individual provider Active NPI

Miriam Sussman, PA-C

  • Physician Assistant
  • Greenwich, CT
National Provider Identifier
1841752300
Registry record updated May 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
023316 Issued in NY
Practice address
5 Perryridge Rd
Greenwich, CT 06830-4697
Phone
(203) 863-3000
NPI assigned
Apr 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 023316 NY Primary

Addresses

Primary practice location

5 Perryridge Rd
Greenwich, CT 06830-4697

Mailing address

1735 Willow CT
Far Rockaway, NY 11691-6200

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
I20210211002233 NY Practitioner - Physician Assistant 4486069069 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

Hospital & facility affiliations

  • Montefiore Medical Center Hospital, Bronx, NY, CCN 330059

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
023316NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jan 18, 2021 Accepting new patients
Montefiore Medical Center CurrentSince Jan 18, 2021 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

1825 Eastchester Rd
Bronx, NY 10461
Phone (718) 904-2000

600 E 233rd St
Bronx, NY 10466
Phone (718) 920-1640

2175 Quarry Rd
Bronx, NY 10457
Phone (718) 960-3900

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: msussman@montefioredirect.com
  • Direct secure messaging: msussman428825@direct.ynhh.org

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556755200000",
    "number": "1841752300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 WILLOW CT",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116916200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 PERRYRIDGE RD",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068304697",
            "telephone_number": "203-863-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSSMAN",
        "first_name": "MIRIAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-03",
        "last_updated": "2019-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "023316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwich, CT

Sources for this page

Verify at the official NPI Registry.