NPIMap

Organization Active NPI

Stony Brook Surgical Associates, University Faculty Practice Corporati

  • Surgery Physician
  • Stony Brook, NY
National Provider Identifier
1063468536
Registry record updated Dec 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
STONY BROOK SURGICAL ASSOCIATES, UNIVERSITY FACULTY PRACTICE CORPORATI
Practice address
Suny @ Stony Brook
HSC, L19, RM 020
Stony Brook, NY 11794-0001
Phone
(631) 444-8278
NPI assigned
May 26, 2006
Last updated
Dec 22, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2014

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

Authorized official

Name
Mark Talamini, M.D.
Title
Chair Person
Phone
(631) 444-8278

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

Suny @ Stony Brook
HSC, L19, RM 020
Stony Brook, NY 11794-0001

Mailing address

PO Box 1554
Stony Brook, NY 11790-0988
Phone (631) 444-8278

Other identifiers 1

IdentifierTypeStateIssuer
00570558MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040202000318 NY Part B Supplier - Clinic/Group Practice 0345143749 Receives reassigned benefits from 139 practitioners
Practice locations: Stony Brook, NY; Southold, NY; Southampton, NY; Hampton Bays, NY; Smithtown, NY; Sayville, NY; Riverhead, NY; New York, NY…

National Provider Directory

National Provider Directory

Locations

23 S Howell Ave
Ste D
Centereach, NY 11720
Phone (631) 444-2274

23 S Howell Ave
Ste G
Centereach, NY 11720
Phone (631) 444-1279

500 Commack Rd
Ste 102A
Commack, NY 11725
Phone (631) 638-0130

140 N Belle Mead Ave
Ste D
East Setauket, NY 11733
Phone (631) 638-2200

4 Smith Haven Mall
Ste 101
Lake Grove, NY 11755
Phone (631) 444-7337

31 E Main St
#3
Riverhead, NY 11901

160 Main St
#3
Sayville, NY 11782
Phone (631) 319-4747

14 Technology Dr
Setauket, NY 11733
Phone (516) 444-1357

222 E Middle Country Rd
Ste 209
Smithtown, NY 11787
Phone (631) 638-0800

300 E Middle Country Rd
Smithtown, NY 11787
Phone (631) 265-3727

100 Nicolls Rd
#8191
Stony Brook, NY 11790
Phone (631) 444-8492

Interoperability endpoints

  • Direct secure messaging: travis.bench@direct.stonybrookmedicine.edu

Practitioners & affiliated clinicians

Practitioners 193

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 193

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419206400000",
    "number": "1063468536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1554",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900988",
            "telephone_number": "631-444-8278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SUNY @ STONY BROOK",
            "address_2": "HSC, L19, RM 020",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-444-8278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONY BROOK SURGICAL ASSOCIATES, UNIVERSITY FACULTY PRACTICE CORPORATI",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2014-12-22",
        "status": "A",
        "authorized_official_last_name": "TALAMINI",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CHAIR PERSON",
        "authorized_official_telephone_number": "631-444-8278",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00570558",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.