Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Eddy St Surin

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1821896754

Eddy St Surin is a Nurse Practitioner in Summit, New Jersey. Qualified in 2023, 3 years ago. Practices with Practice Associates Medical Group, a 1,403-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
3
Licensed in
NJ
In the registry since
2025
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Practice location Address checks out

99 Beauvoir Ave
Summit, NJ 07901-3533
Phone: (908) 522-2000
Fax: (908) 522-2280
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 26NJ15088300 (NJ)

Record details

NPI number1821896754
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMarch 6, 2025
Last updated in NPPESMarch 6, 2025
Certification dateMarch 6, 2025
Mailing address99 Beauvoir Ave, Summit, NJ 07901-3533

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Practice Associates Medical Group — 1403 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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