Individual provider Active NPI

Alyssa Stauber, MD

  • Diagnostic Radiology Physician
  • Manhasset, NY
National Provider Identifier
1033613492
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
323629-01 Issued in NY
Practice address
300 Community Dr
Manhasset, NY 11030-3816
Phone
(516) 562-4797
NPI assigned
Mar 21, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X 323629-01 NY Primary

Addresses

Primary practice location

300 Community Dr
Manhasset, NY 11030-3816

Mailing address

370 E 76TH St Apt A801
New York, NY 10021-0249
Phone (516) 509-4161

Other practice location 1

Maimonides Medical Center
4802 10th avenue
brooklyn, NY 11219
Phone (718) 283-8997

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
I20240307004220 NY Practitioner - Diagnostic Radiology 0547505521 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Florida International Univ, College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Delaware Radiology Associates PAGroup PAC ID 1557620036, 61 clinicians
Lenox Hill Radiology and Medical Imaging Associates PCGroup PAC ID 2264424712, 245 clinicians

Practice addresses (Care Compare)

346 W 22ND St
Apt 1
New York, NY 10011-2670
Phone (585) 218-8012

61 E 77TH St
New York, NY 10075-1817
Phone (212) 772-3111

Merit-based Incentive Payment System (MIPS)

Final score
81.08 of 100Reported as group
Quality
62.84
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
323629-01NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Delaware Radiology Associates PA Diagnostic Radiology CurrentSince Jun 1, 2024 Accepting new patients
Borg & Ide Imaging, PC Diagnostic Radiology CurrentSince Jul 1, 2026 Accepting new patients
Hudson Valley Radiology Associates PLLC Diagnostic Radiology CurrentSince Jan 3, 2024 Accepting new patients
Lenox Hill Radiology & Medical Imaging Associates, PC Diagnostic Radiology CurrentSince Jan 3, 2024 Accepting new patients
Park West Radiology, PC Diagnostic Radiology PastSince Jul 1, 2008 Accepting new patients

Locations

27443 Network Pl
Chicago, IL 60673

29493 Network Pl
Chicago, IL 60673

8940 56th Ave
Flushing, NY 11373
Phone (718) 335-5532

18 Squadron Blvd
New City, NY 10956
Phone (845) 368-3002

315 W 57th St
Ste LL4
New York, NY 10019
Phone (212) 698-5300

61 E 77th St
New York, NY 10075
Phone (212) 772-2130

995 Senator Keating Blvd
Bldg 3
Rochester, NY 14618
Phone (585) 241-6600

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1033613492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 E 76TH ST APT A801",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100210249",
            "telephone_number": "516-509-4161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 COMMUNITY DR",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303816",
            "telephone_number": "516-562-4797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Maimonides Medical Center",
            "address_2": "4802 10th avenue",
            "address_purpose": "LOCATION",
            "city": "brooklyn",
            "state": "NY",
            "postal_code": "11219",
            "country_code": "US",
            "telephone_number": "718-283-8997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAUBER",
        "first_name": "ALYSSA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-21",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "323629-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

Verify at the official NPI Registry.