Individual provider Active NPI

Edward Stark, M.D.

  • Urology Physician
  • New York, NY
National Provider Identifier
1093727166
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
179696 Issued in NY
Practice address
355 W 52ND St
New York, NY 10019-6239
Phone
(646) 754-2100
Fax
(646) 754-2148
NPI assigned
Aug 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 041680 GA
Urology Physician 208800000X 179696 NY Primary

Addresses

Primary practice location

355 W 52ND St
New York, NY 10019-6239

Mailing address

355 W 52ND St
New York, NY 10019-6239
Phone (646) 754-2100

Other identifiers 2

IdentifierTypeStateIssuer
340015407OtherGARAILROAD MEDICARE
000707891GMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address edward.stark.p1@direct.gupa.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NY2 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
I20101206000254 GA Practitioner - Urology 6103999123 Reassigns benefits to 2 organizations
I20231130001933 NY Practitioner - Urology 6103999123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Georgia Urology, PAGroup PAC ID 8921094376, 99 clinicians
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

1223 Friendship Rd
Braselton, GA 30517-5608
Phone (678) 205-8387

355 W 52ND St
New York, NY 10019-6239
Phone (646) 778-5555

900 Towne Lake Pkwy
Suite 200
Woodstock, GA 30189-1603
Phone (678) 494-9201

Hospital & facility affiliations

  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

Merit-based Incentive Payment System (MIPS)

Final score
78.21 of 100Reported as group
Quality
52.19
Promoting interoperability
98
Improvement activities
40
Cost
76.84

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041680GAMDUrology Physician
179696NYMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Urological Professional Services, LLC Urology CurrentSince Nov 1, 2014 Accepting new patients
Georgia Urology, PA CurrentSince Oct 1, 1997 Accepting new patients
Georgia Urology PA Urology CurrentSince Oct 1, 1997 Accepting new patients
New York University CurrentSince Jan 1, 2024 Accepting new patients
Georgia Urology PA Urology Current Accepting new patients
New York University CurrentSince Jan 1, 2024 Accepting new patients

Locations

4450 Calibre Xing NW
Acworth, GA 30101
Phone (770) 607-1893

500 Medical Center Blvd
Ste 220
Lawrenceville, GA 30046
Phone (770) 963-2451

1930 Brannan Rd
McDonough, GA 30253
Phone (678) 284-4040

1700 Tree Ln
Ste 420
Snellville, GA 30078
Phone (770) 979-9427

900 Towne Lake Pkwy
Ste 200
Woodstock, GA 30189
Phone (678) 494-9201

360 W 31st St
Fl 3
New York, NY 10001
Phone (646) 987-3436

355 W 52nd St
New York, NY 10019
Phone (646) 754-2100

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: estark614152@nyumc.direct-ci.com
  • Direct secure messaging: edward.stark.p1@direct.gupa.nextgenshare.com
  • Direct secure messaging: edward.stark@gadirect.net

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 7

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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1093727166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 W 52ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100196239",
            "telephone_number": "646-754-2100",
            "fax_number": "646-754-2148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 W 52ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100196239",
            "telephone_number": "646-754-2100",
            "fax_number": "646-754-2148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "041680",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "179696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "340015407",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000707891G",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edward.stark.p1@direct.gupa.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "500 Medical Center Blvd",
            "address_2": "Suite 220",
            "city": "Lawrenceville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.