Suellen Elmendorf, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F336062-1 Issued in NY

Practice address

230 Crispell Rd
Olivebridge, NY 12461-5446

Phone

(845) 657-6532

NPI assigned

Apr 15, 2010

Sex

Female

Sole proprietor

Yes

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Westchester Medical Center Advanced Physician Services, PC

  • Surgery Physician
  • Valhalla, NY
  • NPI 1912131392
  Medicare reassignment

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

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1851617880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 CRISPELL RD",
            "city": "OLIVEBRIDGE",
            "state": "NY",
            "postal_code": "124615446",
            "telephone_number": "845-657-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 CRISPELL RD",
            "city": "OLIVEBRIDGE",
            "state": "NY",
            "postal_code": "124615446",
            "telephone_number": "845-657-6532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELMENDORF",
        "first_name": "SUELLEN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-15",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F336062-1",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "345540",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerren Bitner, LCSWR
• Courtnie Burke, LCAT
• Virginia A Castrogiovanni, RN
• Jeannette Grace Duffau, RN
• Mary Ann Teresa Fraser, CCC-SLP
• Lori Beth Gundberg, LPN
• Harmonic Adult Health NP PLLC
• Constance Kieltyka, CNM
• Elise Lark, PHD, LCSW, OSW-C

• Family Nurse Practitioner in Olivebridge, NY
• Providers in Olivebridge, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.