Individual provider Active NPI

Susan V Massey, A.N.P.

  • Nurse Practitioner
  • New York, NY
National Provider Identifier
1962731240
Registry record updated Dec 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
302425 Issued in NY
Practice address
160 E 34TH St
New York, NY 10016
Phone
(212) 731-5673
Fax
(212) 751-5502
NPI assigned
Dec 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2009

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 302425 NY Primary

Addresses

Primary practice location

160 E 34TH St
New York, NY 10016

Mailing address

160 E 34TH St
New York, NY 10016
Phone (212) 731-5673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20160122001524 CA Practitioner - Nurse Practitioner 2466583786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11540 Santa Monica Blvd
Suite 203
Los Angeles, CA 90025-7905
Phone (310) 403-2765

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
21114CAMDSurgical Oncology Physician
302425NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific West Coast Health Medical Therapy Center Inc. CurrentSince Feb 6, 2019 Accepting new patients
L.Wiener C.Ross Medical Corp Past Accepting new patients
Boulevard Pharmacy Inc Past Accepting new patients

Locations

11540 Santa Monica Blvd
Ste 201
Los Angeles, CA 90025
Phone (310) 428-8065

11540 Santa Monica Blvd
Ste 203
West Los Angeles, CA 90025
Phone (310) 403-2765

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1260835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260835200000",
    "number": "1962731240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 E 34TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10016",
            "telephone_number": "212-731-5673",
            "fax_number": "212-751-5502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E 34TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10016",
            "telephone_number": "212-731-5673",
            "fax_number": "212-751-5502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSEY",
        "first_name": "SUSAN",
        "middle_name": "V",
        "credential": "A.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-15",
        "last_updated": "2009-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "302425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.