Sujin Son, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

028838-01 Issued in NY

Practice address

100 Port Washington Blvd
Roslyn, NY 11576-1347

Phone

(516) 562-6605

Fax

(516) 562-6612

NPI assigned

Sep 20, 2022

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Progressive Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Uniondale, NY
  • NPI 1588098172
  Medicare reassignment
• St. Francis Hospital

  dba St. Francis Hospitalists

  • General Acute Care Hospital
  • Roslyn, NY
  • NPI 1760704811
  Medicare reassignment
• St Francis Hospital United States Catholic Conference

  dba St Francis Ekg

  • General Acute Care Hospital
  • Roslyn, NY
  • NPI 1750439030
  NPD
• St. Francis Hospital

  • Cardiovascular Disease Physician
  • West Islip, NY
  • NPI 1528386810
  NPD

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

{
    "created_epoch": "1663632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1922721471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 BOND ST PH 3",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212002",
            "telephone_number": "713-396-6504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PORT WASHINGTON BLVD",
            "city": "ROSLYN",
            "state": "NY",
            "postal_code": "115761347",
            "telephone_number": "516-562-6605",
            "fax_number": "516-562-6612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SON",
        "first_name": "SUJIN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-20",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "028838-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Smith, P.A.
• Benjamin Alex Solomon
• Haylee Alexa Solomon, DPT
• Ilene Solomon, PH.D.
• Soma Fit Physical Therapy PLLC
• Parviz Soomekh, M.D.
• Martine Amy Soren, SW INTERN
• Marlene Sotelo-Dynega, PSY.D.
• Jack Soterakis, M.D.
• Alexandra J Spadaro, PA

• Physician Assistant in Roslyn, NY
• Providers in Roslyn, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; 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.