Active NPI
Susan Ellen Stopek, MD
- Psychiatry Physician
- East Setauket, NY
National Provider Identifier
1073559308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 135958
- Practice address
- 210 N Belle Mead Rd
East Setauket, NY 11733-3458 - Phone
- (631) 689-1400
- Fax
- (631) 689-1595
- NPI assigned
- Jun 22, 2006
- Last updated
- Jul 9, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 135958 | NY | Primary |
Addresses
Primary practice location
210 N Belle Mead Rd
East Setauket, NY 11733-3458
Mailing address
210 N Belle Mead Rd
East Setauket, NY 11733-3458
Phone (631) 689-1400
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0067035 | Other | NY | GHI |
| 00804435 | Medicaid | NY | |
| 064846 | Other | NY | VYTRA |
| 74A711 | Other | NY | EMPIRE BLUE |
| P560482 | Other | NY | OXFORD |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 135958 | NY | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1073559308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 N BELLE MEAD RD",
"city": "EAST SETAUKET",
"state": "NY",
"postal_code": "117333458",
"telephone_number": "631-689-1400",
"fax_number": "631-689-1595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 N BELLE MEAD RD",
"city": "EAST SETAUKET",
"state": "NY",
"postal_code": "117333458",
"telephone_number": "631-689-1400",
"fax_number": "631-689-1595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOPEK",
"first_name": "SUSAN",
"middle_name": "ELLEN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-22",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "135958",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "0067035",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00804435",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VYTRA",
"identifier": "064846",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BLUE",
"identifier": "74A711",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P560482",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Setauket, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.