Active NPI
Jeffrey Stern, M.D.
- Internal Medicine Physician
- Stamford, CT
National Provider Identifier
1083979066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 65003
- Practice address
- 2009 Summer St
Stamford, CT 06905-5023 - Phone
- (917) 697-9670
- NPI assigned
- Jul 6, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 290843 | NY | |
| Internal Medicine Physician | 207R00000X | 25MA10257400 | NJ | |
| Addiction Medicine (Internal Medicine) Physician | 207RA0401X | ME133449 | FL | |
| Internal Medicine Physician | 207R00000X | 65003 | CT | Primary |
Addresses
Primary practice location
2009 Summer St
Stamford, CT 06905-5023
Mailing address
2960 NE 207TH St Unit 1108
Aventura, FL 33180-1455
Phone (305) 224-2707
Other practice location 1
450 Clarkson Avenue
Box 1262
Brooklyn, NY 11203
Phone (718) 270-8000
Other practice location 2
2960 NE 207th St Unit 1108
Aventura, FL 33180
Phone (305) 224-2707
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 |
|---|---|---|---|
| 25MA10257400 | NJ | MD | Internal Medicine Physician |
| 290843 | NY | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584921600000",
"number": "1083979066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2960 NE 207TH ST UNIT 1108",
"city": "AVENTURA",
"state": "FL",
"postal_code": "331801455",
"telephone_number": "305-224-2707",
"fax_number": "844-867-3298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2009 SUMMER ST",
"city": "STAMFORD",
"state": "CT",
"postal_code": "069055023",
"telephone_number": "917-697-9670"
}
],
"practiceLocations": [
{
"address_1": "450 Clarkson Avenue",
"address_2": "Box 1262",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "11203",
"country_code": "US",
"telephone_number": "718-270-8000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2960 NE 207th St Unit 1108",
"address_purpose": "LOCATION",
"city": "Aventura",
"state": "FL",
"postal_code": "33180",
"country_code": "US",
"telephone_number": "305-224-2707",
"fax_number": "844-867-3298",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STERN",
"first_name": "JEFFREY",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-07-06",
"last_updated": "2020-03-23",
"certification_date": "2020-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "290843",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NJ",
"license": "25MA10257400",
"primary": false
},
{
"code": "207RA0401X",
"taxonomy_group": "",
"desc": "Internal Medicine, Addiction Medicine",
"state": "FL",
"license": "ME133449",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CT",
"license": "65003",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Stamford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.