Individual provider Active NPI

Susan Carol Hubbard, LM

  • Midwife
  • New York, NY
National Provider Identifier
1942752431
Registry record updated Oct 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
F001754 Issued in NY
Practice address
124 W 109TH St Apt 3a
New York, NY 10025-2515
Phone
(646) 267-4521
NPI assigned
Oct 31, 2016
Last updated
Oct 31, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X F001754 NY Primary

Addresses

Primary practice location

124 W 109TH St Apt 3a
New York, NY 10025-2515

Mailing address

124 W 109TH St Apt 3a
New York, NY 10025-2515
Phone (646) 267-4521

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170224002269 NY Practitioner - Certified Nurse Midwife (CNM) 4587948237 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Morris Heights Health Center, Inc.Group PAC ID 3072798172, shared by 6 NPIs, 49 clinicians

Practice addresses (Care Compare)

85 W Burnside Ave
Bronx, NY 10453-4015
Phone (718) 483-1270

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001754NYMDAcupuncturist
F001754NYMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
Urban Strategies Brookdale Family Care Center Inc CurrentSince Apr 17, 2019 Accepting new patients
Brookdale Family Care Center, Inc. CurrentSince Nov 10, 2018 Accepting new patients
The Brookdale Hospital Medical Center CurrentSince Jan 22, 2017 Accepting new patients
Brookdale Hospital Medical Center CurrentSince Jan 22, 2017 Accepting new patients
Brookdale Family Care Center, Inc. CurrentSince Nov 10, 2018 Accepting new patients

Locations

1 Brookdale Plz
Brooklyn, NY 11212
Phone (718) 240-5212

1095 Flatbush Ave
Brooklyn, NY 11226
Phone (718) 240-5132

1235 Linden Blvd
Fl 2
Brooklyn, NY 11212
Phone (718) 240-7143

1873 Eastern Pkwy
Brooklyn, NY 11233
Phone (718) 240-5133

Networks

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

Interoperability endpoints

  • Direct secure messaging: susan.hubbard.p1@direct.mhhc.nextgenshare.com

Organizations & group practices 5

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": "1477872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477872000000",
    "number": "1942752431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 W 109TH ST APT 3A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100252515",
            "telephone_number": "646-267-4521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 W 109TH ST APT 3A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100252515",
            "telephone_number": "646-267-4521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBARD",
        "first_name": "SUSAN",
        "middle_name": "CAROL",
        "name_prefix": "Ms.",
        "credential": "LM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-31",
        "last_updated": "2016-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "NY",
            "license": "F001754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.