NPIMap

Individual provider Active NPI

Avraham Bluestone, MD,PHD

  • Neuroradiology Physician
  • Stony Brook, NY
National Provider Identifier
1003072950
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
256825 Issued in NY
Practice address
Stony Brook Radiology
HSC L4, Room 120
Stony Brook, NY 11794-8460
Phone
(631) 444-5400
Fax
(631) 444-7538
NPI assigned
Jul 31, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 256825 NY
Neuroradiology Physician 2085N0700X 256825 NY Primary

Addresses

Primary practice location

Stony Brook Radiology
HSC L4, Room 120
Stony Brook, NY 11794-8460

Mailing address

Stony Brook Radiology
HSC L4, Room 120
Stony Brook, NY 11794-8460
Phone (631) 444-5400

Other identifiers 1

IdentifierTypeStateIssuer
12249898MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address avraham.bluestone@direct.stonybrookmedicine.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110728000550 NY Practitioner - Diagnostic Radiology 3577731975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
State University of New York Downstate Medical Center, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-3407
Phone (631) 638-2121

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-5400

201 Manor PL
Greenport, NY 11944-1222
Phone (631) 477-1000

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393
  • Long Island Community Hospital Hospital, Patchogue, NY, CCN 330141
  • John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Radiology, University Faculty Practice Corporation Diagnostic Radiology CurrentSince May 15, 2012 Accepting new patients
Stony Brook Community Medical, P.C. Diagnostic Radiology Past Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Past Accepting new patients

Locations

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/929sni9vNtBT8k3NbtgAnVZlZv_TYNXC/
  • Direct secure messaging: avraham.bluestone@direct.stonybrookmedicine.edu

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1217462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1003072950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "STONY BROOK RADIOLOGY",
            "address_2": "HSC L4, ROOM 120",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948460",
            "telephone_number": "631-444-5400",
            "fax_number": "631-444-7538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STONY BROOK RADIOLOGY",
            "address_2": "HSC L4, ROOM 120",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948460",
            "telephone_number": "631-444-5400",
            "fax_number": "631-444-7538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUESTONE",
        "first_name": "AVRAHAM",
        "name_prefix": "Dr.",
        "credential": "MD,PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-31",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "256825",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "NY",
            "license": "256825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12249898",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "avraham.bluestone@direct.stonybrookmedicine.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "Stony Brook Radiology",
            "address_2": "HSC L4, Room 120",
            "city": "Stony Brook",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117948460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.