Active NPI
Stephen J Danziger, MD
- Dermatology Physician
- Brooklyn, NY
National Provider Identifier
1033118310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 104132
- Practice address
- 35 Prospect Park W Apt 12D
Brooklyn, NY 11215-7806 - Phone
- (718) 638-3640
- NPI assigned
- Jul 19, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 104132 | NY | Primary |
Addresses
Primary practice location
35 Prospect Park W Apt 12D
Brooklyn, NY 11215-7806
Mailing address
35 Prospect Park W Apt 12D
Brooklyn, NY 11215-7806
Phone (718) 638-3640
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00180956 | Medicaid | NY |
Electronic endpoints 5
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) | |
| FHIR URL | https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) | |
| FHIR URL | https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ | Health Information Exchange (HIE) | |
| Direct Messaging Address | sjd9004@direct.nyp.org | Direct | |
| FHIR URL | https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104132 | NY | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kings Physician Services, PC | Current | Accepting new patients | |
| Kings Physician Services, PC | Current | Accepting new patients | |
| Park Slope Medical Health Provider, PC | Past | Accepting new patients |
Locations
506 6th St
Brooklyn, NY 11215
Phone (718) 780-3279
506 6th St
#400
Brooklyn, NY 11215
Phone (718) 246-8614
506 6th St
Ste B
Brooklyn, NY 11215
Phone (718) 780-3677
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
Interoperability endpoints
- sjd9004@direct.nyp.org
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.
-
- Diagnostic Radiology Physician
- Brooklyn, NY
- NPI 1083045090
-
dba Kings Emergency Physician Services
- Emergency Medicine Physician
- Brooklyn, NY
- NPI 1326698879
-
- Hematology & Oncology Physician
- Brooklyn, NY
- NPI 1255611919
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694736000000",
"number": "1033118310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 PROSPECT PARK W APT 12D",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112157806",
"telephone_number": "718-638-3640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35 PROSPECT PARK W APT 12D",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112157806",
"telephone_number": "718-638-3640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANZIGER",
"first_name": "STEPHEN",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-19",
"last_updated": "2023-09-15",
"certification_date": "2023-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NY",
"license": "104132",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00180956",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "FHIR",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "FHIR",
"address_1": "35 Prospect Park W Apt 12D",
"city": "Brooklyn",
"state": "NY",
"country_code": "US",
"postal_code": "112157806",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "FHIR",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "FHIR",
"address_1": "35 Prospect Park W Apt 12D",
"city": "Brooklyn",
"state": "NY",
"country_code": "US",
"postal_code": "112157806",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
"affiliation": "N",
"endpointDescription": "FHIR",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "FHIR",
"address_1": "35 Prospect Park W Apt 12D",
"city": "Brooklyn",
"state": "NY",
"country_code": "US",
"postal_code": "112157806",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sjd9004@direct.nyp.org",
"affiliation": "N",
"endpointDescription": "direct address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "direct address",
"address_1": "35 Prospect Park W Apt 12D",
"city": "Brooklyn",
"state": "NY",
"country_code": "US",
"postal_code": "112157806",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "FHIR",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "FHIR",
"address_1": "35 Prospect Park W Apt 12D",
"city": "Brooklyn",
"state": "NY",
"country_code": "US",
"postal_code": "112157806",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; 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.