Individual provider Active NPI

Susan M Marks, ANP

  • Adult Health Nurse Practitioner
  • East Meadow, NY
National Provider Identifier
1881840544
Registry record updated Aug 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F304923-1 Issued in NY
Practice address
799 Wenwood Dr
East Meadow, NY 11554-4942
Phone
(516) 857-6481
NPI assigned
Aug 13, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F304923-1 NY Primary

Addresses

Primary practice location

799 Wenwood Dr
East Meadow, NY 11554-4942

Mailing address

799 Wenwood Dr
East Meadow, NY 11554-4942
Phone (516) 857-6481

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
I20120430000371 NY Practitioner - Nurse Practitioner 3173785680 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F304923-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Jul 1, 2012 Accepting new patients
North Shore - Lij Medical PC CurrentSince Jul 1, 2012 Accepting new patients

Locations

300 Community Dr
Plandome, NY 11030

391 N Country Rd
Smithtown, NY 11787
Phone (631) 361-2020

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218585600000",
    "number": "1881840544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "799 WENWOOD DR",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115544942",
            "telephone_number": "516-857-6481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 WENWOOD DR",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115544942",
            "telephone_number": "516-857-6481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKS",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-13",
        "last_updated": "2008-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F304923-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Meadow, NY

Sources for this page

Verify at the official NPI Registry.