Individual provider Active NPI

Justin Margolis, M.D.

  • Vascular Surgery Physician
  • Stony Brook, NY
National Provider Identifier
1083907836
Registry record updated Nov 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
MD60998848 Issued in WA
Practice address
Department of Surgery
Health Sciences Center T19-090
Stony Brook, NY 11794-8191
Phone
(631) 444-2037
Fax
(631) 444-8824
NPI assigned
May 25, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X MD60998848 WA Primary

Addresses

Primary practice location

Department of Surgery
Health Sciences Center T19-090
Stony Brook, NY 11794-8191

Mailing address

419 South 'L' St
Tacoma, WA 98405
Phone (253) 403-8410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161010001253 NY Practitioner - Vascular Surgery 6709174626 Reassigns benefits to 1 organization
I20191224000038 WA Practitioner - Vascular Surgery 6709174626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

1901 S Union Ave
Tacoma, WA 98405-1702

202 N Division St
Auburn, WA 98001-4939

222 State Ave N
Kent, WA 98030-4544
Phone (253) 372-7788

311 S L St
Tacoma, WA 98405-3720

407 14TH Ave SE
Puyallup, WA 98372-3770
Phone (253) 697-1962

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60998848WAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Nov 11, 2019 Accepting new patients
Multicare Health System CurrentSince Nov 11, 2019 Accepting new patients
CHS Physician Partners, P.C CurrentSince Aug 1, 2016 Accepting new patients
Multicare Health System Current Accepting new patients
CHS Physician Partners, PC Current Accepting new patients
Multicare Health System Past Accepting new patients

Locations

245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

300 E Main St
Ste 2
Smithtown, NY 11787
Phone (631) 780-6128

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Organizations & group practices 6

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 3

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": "1306281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574294400000",
    "number": "1083907836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 SOUTH 'L' ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98405",
            "telephone_number": "253-403-8410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF SURGERY",
            "address_2": "HEALTH SCIENCES CENTER T19-090",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948191",
            "telephone_number": "631-444-2037",
            "fax_number": "631-444-8824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARGOLIS",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-25",
        "last_updated": "2019-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "WA",
            "license": "MD60998848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.