Active NPI
Cori Marie Surerus
- Specialist
- Liberty, NY
National Provider Identifier
1891468856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 2583100
- Practice address
- 5 Triangle Rd
Liberty, NY 12754-3368 - Phone
- (845) 747-2580
- NPI assigned
- Jul 27, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Specialist | 174400000X | 2583100 | NY | Primary |
Addresses
Primary practice location
5 Triangle Rd
Liberty, NY 12754-3368
Mailing address
Gerri Gelsomino
Pobox 923
Forestburgh, NY 12777
Phone (845) 747-2580
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 |
|---|---|---|---|
| 2583100 | NY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632268800000",
"number": "1891468856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "GERRI GELSOMINO",
"address_2": "POBOX 923",
"city": "FORESTBURGH",
"state": "NY",
"postal_code": "12777",
"telephone_number": "845-747-2580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 TRIANGLE RD",
"city": "LIBERTY",
"state": "NY",
"postal_code": "127543368",
"telephone_number": "845-747-2580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SURERUS",
"first_name": "CORI",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-27",
"last_updated": "2021-09-22",
"certification_date": "2021-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "2583100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Liberty, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.