Individual provider Active NPI

Richard Phelps Stankus, PHD MD

  • Allergy & Immunology Physician
  • Liverpool, NY
National Provider Identifier
1023119021
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
1743091 Issued in NY
Practice address
7209 Buckley Rd Suite 2X
North Medical Center
Liverpool, NY 13088
Phone
(315) 452-2070
Fax
(315) 452-2074
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 1743091 NY Primary

Addresses

Primary practice location

7209 Buckley Rd Suite 2X
North Medical Center
Liverpool, NY 13088

Mailing address

7209 Buckley Rd Suite 2X
North Medical Center
Liverpool, NY 13088
Phone (315) 452-2070

Other identifiers 1

IdentifierTypeStateIssuer
01069745MedicaidNY

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101029000430 NY Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 3779777149 Practice locations: Liverpool, NY; Auburn, NY

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Internal Medicine
Education
Tulane University School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5100 W Taft Rd
Suite 2X
Liverpool, NY 13088-4841
Phone (315) 452-2070

7209 Buckley Rd
2X
Liverpool, NY 13088-3846

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1743091NYMDAllergy & Immunology Physician

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1023119021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7209 BUCKLEY RD SUITE 2X",
            "address_2": "NORTH MEDICAL CENTER",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "13088",
            "telephone_number": "315-452-2070",
            "fax_number": "315-452-2074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7209 BUCKLEY RD SUITE 2X",
            "address_2": "NORTH MEDICAL CENTER",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "13088",
            "telephone_number": "315-452-2070",
            "fax_number": "315-452-2074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANKUS",
        "first_name": "RICHARD",
        "middle_name": "PHELPS",
        "name_prefix": "Dr.",
        "credential": "PHD MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NY",
            "license": "1743091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01069745",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

Verify at the official NPI Registry.