Individual provider Active NPI

Alyssa Jenine Stare

  • Acupuncturist
  • Sayville, NY
National Provider Identifier
1043864200
Registry record updated Jul 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
006235 Issued in NY
Practice address
160 Middle Rd Ste 1
Sayville, NY 11782-3126
Phone
(631) 239-8262
NPI assigned
Jul 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 031289 NY
Acupuncturist 171100000X 006235 NY Primary

Addresses

Primary practice location

160 Middle Rd Ste 1
Sayville, NY 11782-3126

Mailing address

160 Middle Rd Ste 1
Sayville, NY 11782-3126
Phone (631) 239-8262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
006235NYMDClinical Psychologist
031289NYMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1564099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564099200000",
    "number": "1043864200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 MIDDLE RD STE 1",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117823126",
            "telephone_number": "631-239-8262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 MIDDLE RD STE 1",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117823126",
            "telephone_number": "631-239-8262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARE",
        "first_name": "ALYSSA",
        "middle_name": "JENINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-26",
        "last_updated": "2019-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "031289",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "006235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sayville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.