Stuart Trust, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

1117151 Issued in NY

Practice address

63 South First St
Fulton, NY 13069

Phone

(315) 598-6785

Fax

(315) 592-3571

NPI assigned

Jan 4, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 12

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• River View Pediatrics, PC

  • Pediatric Adolescent Medicine Physician
  • Fulton, NY
  • NPI 1831401850
  NPD (past)

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104973833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 SOUTH FIRST ST",
            "city": "FULTON",
            "state": "NY",
            "postal_code": "13069",
            "telephone_number": "315-598-6785",
            "fax_number": "315-592-3571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 SOUTH FIRST ST",
            "city": "FULTON",
            "state": "NY",
            "postal_code": "13069",
            "telephone_number": "315-598-6785",
            "fax_number": "315-592-3571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUST",
        "first_name": "STUART",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "1117151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS CARE",
            "identifier": "040426016443",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHILD HEALTH PLUS",
            "identifier": "100039145101",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANTAGE HEALTH PLAN",
            "identifier": "00020880201",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNOW",
            "identifier": "000916582001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00510678",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "4570301",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00020880201",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "894426",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100039145101",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "265841",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TOTAL CARE",
            "identifier": "395",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "154507",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard R Thompson, M.D.
• Lisa Marie Thrash, LPN
• Dilvir S Toor, DDS
• Mark Louis Toscano, RPH.
• Kimberley Trail
• Mikaela Tubolino, LMHC
• Garrett Andrew Turtura, LIMITED PERMIT MHC
• Dorothy Tyler, R.PH.
• Sandra L Upcraft, OPHTHALMIC DISPENSER
• Upstate Pain Medicine PC

• Pediatrics Physician in Fulton, NY
• Providers in Fulton, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.