Individual provider Active NPI

Susan M Trees, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Central Islip, NY
National Provider Identifier
1912219841
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
402351 Issued in NY
Practice address
159 Carleton Ave
Central Islip, NY 11722
Phone
(631) 650-2510
NPI assigned
Jul 8, 2010
Last updated
May 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 402351 NY Primary
Registered Nurse 163W00000X 525012 NY

Addresses

Primary practice location

159 Carleton Ave
Central Islip, NY 11722

Mailing address

159 Carleton Ave
Central Islip, NY 11722-4172
Phone (631) 650-2510

Other identifiers 1

IdentifierTypeStateIssuer
402351OtherNYLICENSE NUMBER

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
I20181009002042 NY Practitioner - Nurse Practitioner 3779835335 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

120 Plant Ave
Hauppauge, NY 11788-3827
Phone (631) 650-2510

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
525012NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Long Island Select Healthcare, Inc. CurrentSince Aug 21, 2018 Accepting new patients
Sun River Health Inc Current Accepting new patients
Sun River Health Inc. CurrentSince Oct 19, 2020 Accepting new patients
Long Island Select Healthcare, Inc. CurrentSince Aug 21, 2018 Accepting new patients
Operation Engage Psychiatric Services Current Accepting new patients
Aid to the Developmentally Disabled, Inc CurrentSince Dec 1, 2021 Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

159 Carleton Ave
Central Islip, NY 11722
Phone (631) 439-4300

120 Plant Ave
Hauppauge, NY 11788
Phone (631) 273-1300

1641 Route 112
Ste C
Medford, NY 11763
Phone (631) 291-2385

883 E Main St
Riverhead, NY 11901
Phone (631) 284-5500

901 E Main St
Ste 508
Riverhead, NY 11901
Phone (631) 727-6220

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CCJFAD

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557964800000",
    "number": "1912219841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 CARLETON AVE",
            "city": "CENTRAL ISLIP",
            "state": "NY",
            "postal_code": "117224172",
            "telephone_number": "631-650-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 CARLETON AVE",
            "city": "CENTRAL ISLIP",
            "state": "NY",
            "postal_code": "11722",
            "telephone_number": "631-650-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREES",
        "first_name": "SUSAN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-08",
        "last_updated": "2019-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402351",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "525012",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "402351",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Central Islip, NY

Sources for this page

Verify at the official NPI Registry.