Jeffrey M Stark, D.P.M.

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

NOO3165-1 Issued in NY

Practice address

1 Duncan PL
Oceanside, NY 11572-1306

Phone

(516) 764-3500

Fax

(516) 536-4236

NPI assigned

Jun 17, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273104000000",
    "number": "1114922994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DUNCAN PL",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721306",
            "telephone_number": "516-764-3500",
            "fax_number": "516-536-4236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DUNCAN PL",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721306",
            "telephone_number": "516-764-3500",
            "fax_number": "516-536-4236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "JEFFREY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2010-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NY",
            "license": "NOO3165-1",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "N003165-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Frances St. Jean, PHARMD
• Lisa Michelle Staffa, MS CCC SLP
• Barbara A Staiano, PA
• Nicole Stamm, N.P.
• Nancy M Stankewick, MS ED
• Lee D Stein, M.D.
• Steven I Friedman M D P C
• Steven Mitchnick, DMD PC
• Pilar A Stevens-Haynes, MD
• Charles Sticco, DO

• Primary Podiatric Medicine Podiatrist in Oceanside, NY
• Providers in Oceanside, NY by specialty
• Primary Podiatric Medicine Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2010; 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.