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

Kleedy St Surin, PA

Individual provider Physician Assistant · NPI 1760904163

Kleedy St Surin, PA is a Physician Assistant in Staten Island, New York. Qualified in 2017, 9 years ago. Practices with Kings Medical Family Practice, PC, a 19-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
9
Licensed in
NY
In the registry since
2017
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

475 Seaview Ave
Staten Island, NY 10305-3436
Phone: (718) 226-9000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 021007 (NY)

Record details

NPI number1760904163
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedJuly 7, 2017
Last updated in NPPESOctober 23, 2020
Certification dateOctober 23, 2020

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Kings Medical Family Practice, P.C. — 19 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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