Elie R Soussan, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

25MA08834200 Issued in NJ

Practice address

34 Sycamore Ave
Suite 2a
Little Silver, NJ 07739-1228

Phone

(732) 747-9310

Fax

(732) 747-9320

NPI assigned

Jul 2, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lifeline Medical Associates LLCGroup PAC ID 1456332170, 155 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Monmouth Medical Center Hospital, Long Branch, NJ, CCN 310075

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: elie.soussan.1@6387.direct.athenahealth.com

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.

• Lifeline Medical Associates, LLC

  • Obstetrics & Gynecology Physician
  • Florham Park, NJ
  • NPI 1821041617
  Medicare reassignment Care Compare group NPD
• Barnabas Health Medical Group PC

  • Specialist
  • Elizabeth, NJ
  • NPI 1841557246
  Medicare reassignment NPD
• Barnabas Health Medical Group PC

  • Durable Medical Equipment & Medical Supplies
  • Hackensack, NJ
  • NPI 1316772668
  NPD
• Monmouth Medical Center Inc

  • General Acute Care Hospital
  • Long Branch, NJ
  • NPI 1609983790
  NPD (past)

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

• Monmouth Medical Center Inc

  • General Acute Care Hospital
  • Long Branch, NJ
  • NPI 1609983790
  Care Compare affiliation

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425340800000",
    "number": "1891958674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 SYCAMORE AVE",
            "address_2": "SUITE 2A",
            "city": "LITTLE SILVER",
            "state": "NJ",
            "postal_code": "077391228",
            "telephone_number": "732-747-9310",
            "fax_number": "732-747-9320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 SYCAMORE AVE",
            "address_2": "SUITE 2A",
            "city": "LITTLE SILVER",
            "state": "NJ",
            "postal_code": "077391228",
            "telephone_number": "732-747-9310",
            "fax_number": "732-747-9320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUSSAN",
        "first_name": "ELIE",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-02",
        "last_updated": "2015-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA08834200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Bacigalupi Smelas, PT
• Anita Ellen Smith, MSW,LCSW, LCADC
• Adi Smolinsky, MD
• Smomedical LLC
• Chana Solomon
• Robert B Sparling, D.C.
• Sports Care and Physical Rehabilitation Inc.
• Megan L Squires, MS, RDN
• Shirah Suero, CNM
• Maureen Sullivan, MASTERS IN ABA

• Obstetrics & Gynecology Physician in Little Silver, NJ
• Providers in Little Silver, NJ by specialty
• Obstetrics & Gynecology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2015; 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.