Susan Moak, RPA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

016149 Issued in NY

Practice address

8100 Oswego Rd
Suite 220
Liverpool, NY 13090-1654

Phone

(315) 652-6551

Fax

(315) 652-9698

NPI assigned

Nov 26, 2012

Last updated

Nov 30, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Susan Michaels Former name

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Crouse Medical Practice PLLCGroup PAC ID 8426189622, 187 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Liverpool, NY, CCN 337255

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smoak@crousemed.medentdirect.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Crouse Medical Practice, PLLC

  • Internal Medicine Physician
  • Syracuse, NY
  • NPI 1922321934
  Medicare reassignment Care Compare group
• Crouse Medical Practice PLLC

  • Physician Assistant
  • East Syracuse, NY
  • NPI 1386990638
  NPD

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

• QC-Medi New York, Inc.

  dba CenterWell Home Health

  • Home Health Agency
  • Syracuse, NY
  • NPI 1912939489
  Care Compare affiliation

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

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512000000000",
    "number": "1871837260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8324 OSWEGO RD",
            "address_2": "SUITE D",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130901085",
            "telephone_number": "315-652-6551",
            "fax_number": "315-652-7039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 OSWEGO RD",
            "address_2": "SUITE 220",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130901654",
            "telephone_number": "315-652-6551",
            "fax_number": "315-652-9698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOAK",
        "first_name": "SUSAN",
        "credential": "RPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-26",
        "last_updated": "2017-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "016149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "MICHAELS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jacob Mir, PA-C
• Nicole Autumn Mirjafari, MD
• Suman Mishra, MD
• Megan Lee Mitchell, D.M.D.
• Austin Mark Mizell, PT, DPT
• Mobile Me LLC
• Jennifer Mokay, P.T.
• Marika Marta Monahan, MS, CCC-SLP
• Nina Mondi, DPT
• Montanaro Chiropractic P.C.

• Physician Assistant in Liverpool, NY
• Providers in Liverpool, NY by specialty
• Physician Assistant in New York

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