Konstantinos Stathopoulos, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

061934 Issued in NY

Practice address

2925 W 19TH St
Brooklyn, NY 11224-2501

Phone

(347) 743-1275

NPI assigned

May 14, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: kstathopoulos1346615@nychhc.direct-ci.com

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.

• Coney Island Medical Practice Plan, P.C.

  • General Practice Physician
  • Brooklyn, NY
  • NPI 1386951762
  Medicare reassignment
• New York City Health and Hospitals Corporation

  dba Jacobi Medical Center

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1679587679
  NPD (past)

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

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1003438938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 147TH ST",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113573040",
            "telephone_number": "347-743-1275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 W 19TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112242501",
            "telephone_number": "347-743-1275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATHOPOULOS",
        "first_name": "KONSTANTINOS",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-14",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "061934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Statewide Medical Care LLC
• Devorah Statfeld
• Itchie Statfeld, MD
• Maria Stathakos
• Henrietta Statham, LCSW
• Station Care PT PC
• Joshua Statman, D.P.T.
• Meyer Statman, D.O.
• Nina Statman, LCSW
• Statmdny

• General Practice Dentistry in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.