Individual provider Active NPI

Suzette Gjonaj, MD

  • Pediatric Pulmonology Physician
  • Hawthorne, NY
National Provider Identifier
1902898588
Registry record updated Jan 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
195109 Issued in NY
Practice address
19 Bradhurst Ave
Ste 1400
Hawthorne, NY 10532-2140
Phone
(914) 493-7585
Fax
(914) 594-4336
NPI assigned
Aug 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X 195109 NY Primary

Addresses

Primary practice location

19 Bradhurst Ave
Ste 1400
Hawthorne, NY 10532-2140

Mailing address

19 Bradhurst Ave
Ste 1400
Hawthorne, NY 10532-2140
Phone (914) 493-7585

Other identifiers 1

IdentifierTypeStateIssuer
01629423MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071016000103 NY Practitioner - Pulmonary DiseasePractitioner - Pediatric Medicine 2163518515 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Networks

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

Organizations & group practices 1

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": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421884800000",
    "number": "1902898588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BRADHURST AVE",
            "address_2": "STE 1400",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105322140",
            "telephone_number": "914-493-7585",
            "fax_number": "914-594-4336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 BRADHURST AVE",
            "address_2": "STE 1400",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105322140",
            "telephone_number": "914-493-7585",
            "fax_number": "914-594-4336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GJONAJ",
        "first_name": "SUZETTE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2015-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "NY",
            "license": "195109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01629423",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, NY

Sources for this page

Verify at the official NPI Registry.