Individual provider Active NPI

Bernard Stark, MD

  • Gastroenterology Physician
  • Manhasset, NY
National Provider Identifier
1063572113
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
135237-1 Issued in NY
Practice address
Nsuh Dept of Medicine Division of Gastroenterology
300 Community Drive
Manhasset, NY 11030
Phone
(516) 562-4281
NPI assigned
Dec 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 135237-1 NY Primary

Addresses

Primary practice location

Nsuh Dept of Medicine Division of Gastroenterology
300 Community Drive
Manhasset, NY 11030

Mailing address

Nsuh Dept of Medicine Division of Gastroenterology
Nsuh Dept of Medicine Division of Gastroenterology
Manhasset, NY 11030
Phone (516) 562-4281

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
I20041222000100 NY Practitioner - GastroenterologyPractitioner - Internal Medicine 6507824596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
New York University School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4295 Hempstead Tpke
Bethpage, NY 11714-5713
Phone (516) 579-6000

Hospital & facility affiliations

  • Chsli St Joseph Hospital Hospital, Bethpage, NY, CCN 330332

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux55

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
135237-1NYMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gastroenterology Care of Li PC Gastroenterology CurrentSince Apr 1, 2014 Accepting new patients

Locations

4295 Hempstead Tpke
Bethpage, NY 11714
Phone (516) 520-2250

94 Gardiners Ave
Levittown, NY 11756
Phone (516) 531-3854

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063572113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NSUH DEPT OF MEDICINE DIVISION OF GASTROENTEROLOGY",
            "address_2": "NSUH DEPT OF MEDICINE DIVISION OF GASTROENTEROLOGY",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "11030",
            "telephone_number": "516-562-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NSUH DEPT OF MEDICINE DIVISION OF GASTROENTEROLOGY",
            "address_2": "300 COMMUNITY DRIVE",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "11030",
            "telephone_number": "516-562-4281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "BERNARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "135237-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

Verify at the official NPI Registry.