Jill M Laureano Surber DO PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

271910 Issued in NY

Legal business name

JILL M LAUREANO SURBER DO PC

Doing business as

Family Medicine of Northern New York

Practice address

20053 Summit View Blvd Ste 1
Watertown, NY 13601-2170

Phone

(315) 755-2560

Fax

(315) 755-2597

NPI assigned

Jul 17, 2014

Last updated

Jan 12, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jill Laureano-Surber, DONPI 1437443132

Title

Owner

Phone

(315) 755-2560

Specialties & licenses 1

Addresses

Other names 1

• FAMILY MEDICINE OF NORTHERN NEW YORK Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jill Laureano-Surber, DO

  • Family Medicine Physician
  • Watertown, NY
  • NPI 1437443132
  Medicare reassignment Care Compare group NPD Authorized official
• Jennifer J Patterson, N.P.

  • Adult Health Nurse Practitioner
  • Watertown, NY
  • NPI 1144616962
  Medicare reassignment Care Compare group NPD
• Hali Jo Reid, NP

  • Family Nurse Practitioner
  • Watertown, NY
  • NPI 1942910674
  Medicare reassignment Care Compare group NPD
• Michael Anthony O'Hagan, P.A.

  • Medical Physician Assistant
  • Watertown, NY
  • NPI 1346579448
  Medicare reassignment Care Compare group
• Elissa D Townsend, FNP-C

  • Family Nurse Practitioner
  • Watertown, NY
  • NPI 1629328422
  Care Compare group NPD
• Michaela Duffy McCargar, FNP

  • Family Nurse Practitioner
  • Watertown, NY
  • NPI 1023764487

  Single Specialty

  NPD

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705017600000",
    "number": "1992112387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20053 SUMMIT VIEW BLVD STE 1",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012170",
            "telephone_number": "315-755-2560",
            "fax_number": "315-755-2597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20053 SUMMIT VIEW BLVD STE 1",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012170",
            "telephone_number": "315-755-2560",
            "fax_number": "315-755-2597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JILL M LAUREANO SURBER DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-17",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A",
        "authorized_official_last_name": "LAUREANO-SURBER",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-755-2560",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "271910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILY MEDICINE OF NORTHERN NEW YORK",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeffrehabilitation Center
• Jeffrey S. Aronowitz, M.D.
• Katelyn Jessmer, LMHC, CASAC
• Chris Anne Jewett, NP
• Timothy M Jewett, PHARM.D
• Brenda Marie Jock Derouin, MA, CAS
• John J Poggi, MD PC (North Country Oncology Hematology)
• Grace Johnson
• Heather Johnson, LMT
• Katherine S. Johnson, PA-C

• Family Medicine Physician in Watertown, NY
• Providers in Watertown, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.