Robert R Surprenant, PA
Physician Assistant, Surgical in Albany, NY. Individual provider (NPI-1).
NPI number1497989404
StatusActive
Last updated in NPPESJun 7, 2016
Details
- NPI
- 1497989404
- Entity type
- Individual (NPI-1)
- Name
- Robert R Surprenant
- Credential
- PA
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 5, 2009
- Last updated
- Jun 7, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AS0400X | Physician Assistant, Surgical | – | – | Yes |
Practice location
315 S Manning Blvd7422 Gab Love
Albany, NY 12208-1707
Phone 518-525-1693
Mailing address
600 Gresham Dr# 5b
Norfolk, VA 23507-1904
Phone 757-388-3198 · Fax 757-388-4242
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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