JOSHTIN DALE ORDONA SULSE
NPI 1790675312
Nurse Practitioner - Adult Health in New York, NY

Q: What is Joshtin Dale Sulse's NPI number?

The NPI number for Joshtin Dale Sulse is 1790675312. It was assigned to this individual provider in the NPPES registry on July 7, 2025.

Q: What is Joshtin Dale Sulse's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Active since July 07, 2025PECOS Enrolled

1275 YORK AVE, NEW YORK, NY 10065(212) 639-2000 Get Directions Write a Review

NPPES record last updated: August 22, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Joshtin Dale Ordona Sulse NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOSHTIN DALE ORDONA SULSE (NPI 1790675312) is an individual adult health provider in New York, New York, licensed in New York (312074) and active in the NPI registry since July 2025. He is enrolled in Medicare PECOS, maintains a secondary practice location in Woodhaven, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1790675312

Entity TypeIndividualMale

Primary Taxonomy363LA2200X

Provider Legal NameJOSHTIN DALE ORDONA SULSE

Location Address1275 YORK AVENew York, NY 10065-6007

Mailing Address7819 91st AveWoodhaven, NY 11421-2935 · (347) 401-0718

Phone(212) 639-2000

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateJuly 7, 2025

Last NPPES UpdateAugust 22, 2025

NPPES CertifiedAugust 22, 2025

✔ NPI 1790675312 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in NY · 312074

Also ListedRegistered NurseTaxonomy 163W00000X · License 777310 (NY)

1275 YORK AVE, New York, NY 10065

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Secondary Practice Location 1

Location 17819 91st AveWoodhaven, NY 11421-2935 · Phone (347) 401-0718

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Joshtin Dale Ordona Sulse is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3476050626

PECOS Enrollment IDI20251007000142

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Joshtin Dale Sulse reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Memorial Anesthesiology Group

Same address

Anesthesiology

1275 YORK AVE
New York, NY 10021

Reassigned Medicare billing, New York enrollment
482 clinicians in this Medicare group

NPI 1467423020 (646) 227-3813

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10065 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$102.04 typical visit price

range $65.69 – $198.19

Typical copayment $25.51 (range $16.42 – $49.54)

Most-billed visit code 99203

Established Patient

$114.88 typical visit price

range $21.20 – $160.66

Typical copayment $28.72 (range $5.30 – $40.16)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. ZANA CORREA NP

Nurse Practitioner (Adult Health)