Active NPI
Susan Kacprzak
- Pediatric Nurse Practitioner
- New York, NY
National Provider Identifier
1851027015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 383430
- Practice address
- 3959 Broadway
New York, NY 10032-1559 - Phone
- (212) 305-5437
- NPI assigned
- Jul 28, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 383430 | NY | Primary |
Addresses
Primary practice location
3959 Broadway
New York, NY 10032-1559
Mailing address
6114 Gates Ave
Ridgewood, NY 11385-3319
Phone (347) 281-0080
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ssk9038@nyp.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 383430 | NY | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658966400000",
"number": "1851027015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6114 GATES AVE",
"city": "RIDGEWOOD",
"state": "NY",
"postal_code": "113853319",
"telephone_number": "347-281-0080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3959 BROADWAY",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100321559",
"telephone_number": "212-305-5437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KACPRZAK",
"first_name": "SUSAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-28",
"last_updated": "2022-07-28",
"certification_date": "2022-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "NY",
"license": "383430",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ssk9038@nyp.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "3959 Broadway",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100321559",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.