Susan Marie Stickevers, MD

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

172707 Issued in NY

Practice address

79 Middleville Rd
Northport, NY 11768-2200

Phone

(631) 261-4400

Fax

(631) 266-6022

NPI assigned

Oct 20, 2006

Sex

Female

Sole proprietor

Yes

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 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: susanstickevers@sunydmc.allscriptsdirect.net

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.

• University Physicians of Brooklyn, Inc.

  • Family Medicine Physician
  • Brooklyn, NY
  • NPI 1366506271
  Medicare reassignment NPD
• University Physicians of Brooklyn, Inc.

  • Orthopaedic Surgery Physician
  • Brooklyn, NY
  • NPI 1386691822
  NPD
• University Physicians of Brooklyn, Inc.

  • Child & Adolescent Psychiatry Physician
  • Brooklyn, NY
  • NPI 1689715476
  NPD

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912089566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 MIDDLEVILLE RD",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117682200",
            "telephone_number": "631-261-4400",
            "fax_number": "631-266-6022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 MIDDLEVILLE RD",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117682200",
            "telephone_number": "631-261-4400",
            "fax_number": "631-266-6022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STICKEVERS",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NY",
            "license": "172707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith A Stamos, OTR/L
• Lorraine Marie Stamp, LCSW
• Melissa Stancanelli, PHARM.D.
• David Adam Stein
• Steven B Lamberg, DDS, P.C.
• Michael Angelo Stoduto, LCSW
• Suffolk Gynecology Group, PC
• Suzanne Elizabeth Sullivan, R.D
• Natalia Suslov, OTR
• Mary Bernadette Sutton Leavy, CTRS

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Northport, NY
• Providers in Northport, NY by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.