Individual provider Active NPI

Thomas Stavro Soussou, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • New York, NY
National Provider Identifier
1942839741
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
335826 Issued in NY
Practice address
159 E 74TH St
New York, NY 10021-3235
Phone
(212) 737-3301
Fax
(212) 734-0407
NPI assigned
Apr 3, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 25MA12624900 NJ
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 335826 NY Primary

Addresses

Primary practice location

159 E 74TH St
New York, NY 10021-3235

Mailing address

159 E 74TH St
New York, NY 10021-3235
Phone (212) 737-3301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1942839741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 E 74TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100213235",
            "telephone_number": "212-737-3301",
            "fax_number": "212-734-0407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 E 74TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100213235",
            "telephone_number": "212-737-3301",
            "fax_number": "212-734-0407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUSSOU",
        "first_name": "THOMAS",
        "middle_name": "STAVRO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-03",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NJ",
            "license": "25MA12624900",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NY",
            "license": "335826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.