Individual provider Active NPI

Susan Lacina, CNP

  • Nurse Practitioner
  • New York, NY
National Provider Identifier
1932252574
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
420363 Issued in NY
Practice address
St Lukes Hosp 1111 Amsterdam Ave
OB GYN Clark 2
New York, NY 10025
Phone
(212) 523-4472
Fax
(212) 523-1723
NPI assigned
Jan 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 420363 NY Primary

Addresses

Primary practice location

St Lukes Hosp 1111 Amsterdam Ave
OB GYN Clark 2
New York, NY 10025

Mailing address

430 E 77TH St
Apt 7F
New York, NY 10021
Phone (212) 861-7419

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
420363NYMDNurse Practitioner

Networks

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

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932252574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 E 77TH ST",
            "address_2": "APT 7F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10021",
            "telephone_number": "212-861-7419",
            "fax_number": "212-523-1723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ST LUKES HOSP 1111 AMSTERDAM AVE",
            "address_2": "OB GYN CLARK 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10025",
            "telephone_number": "212-523-4472",
            "fax_number": "212-523-1723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACINA",
        "first_name": "SUSAN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "420363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.