Individual provider Active NPI

Marianne Surasi, D.P.M.

  • Primary Podiatric Medicine Podiatrist
  • Staten Island, NY
National Provider Identifier
1942472246
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
NOO4727 Issued in NY
Practice address
178 Ocean Ter
Staten Island, NY 10301-4514
Phone
(718) 876-8082
NPI assigned
Mar 26, 2008
Last updated
Mar 26, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X NOO4727 NY Primary

Addresses

Primary practice location

178 Ocean Ter
Staten Island, NY 10301-4514

Mailing address

178 Ocean Ter
Staten Island, NY 10301-4514
Phone (718) 876-8082

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100303001160 NY Practitioner - Podiatry 4183769938 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foot Clinics of New YorkGroup PAC ID 5294626636, 17 clinicians

Practice addresses (Care Compare)

55 E 124TH St
New York, NY 10035-1815
Phone (212) 410-8158

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue112
Removal or shaving of skin growth31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NOO4727NYMDPrimary Podiatric Medicine Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Foot Clinics of New York CurrentSince Jan 5, 2010 Accepting new patients

Locations

55 E 124th St
New York, NY 10035
Phone (212) 410-8112

Networks

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

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, 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": "1206489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206489600000",
    "number": "1942472246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 OCEAN TER",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103014514",
            "telephone_number": "718-876-8082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "178 OCEAN TER",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103014514",
            "telephone_number": "718-876-8082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURASI",
        "first_name": "MARIANNE",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-26",
        "last_updated": "2008-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NY",
            "license": "NOO4727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.