Individual provider Active NPI

Vasileios Kostaras, MD

  • Student in an Organized Health Care Education/Training Program
  • Stony Brook, NY
National Provider Identifier
1144487968
Registry record updated Aug 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
256798 Issued in NY
Practice address
101 Nicolls Road
HSC 19
Stony Brook, NY 11794-8191
Phone
(631) 444-1791
Fax
(631) 444-7689
NPI assigned
May 20, 2008
Last updated
Aug 21, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 256798 NY Primary
Transplant Surgery Physician 204F00000X MT191836 PA

Addresses

Primary practice location

101 Nicolls Road
HSC 19
Stony Brook, NY 11794-8191

Mailing address

101 Nicolls Road
HSC 19
Stony Brook, NY 11794-8191
Phone (631) 444-1791

Other names 1

  • Vasileios Kostaras Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 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
I20170907000788 NY Practitioner - General Surgery 0840563268 Reassigns benefits to 1 organization
I20171023001839 NJ Practitioner - General Surgery 0840563268 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Teaneck, NJ 07666
Phone (201) 833-3000

1 Clara Maass Dr
Belleville, NJ 07109-3550
Phone (973) 450-2000

1100 Clifton Ave
Clifton, NJ 07013-3631
Phone (973) 778-0110

223 N Van Dien Ave
Ridgewood, NJ 07450-2726
Phone (201) 447-8000

250 Old Hook Rd
Westwood, NJ 07675-3123
Phone (201) 383-1035

55 Mdwlands Pkwy
Secaucus, NJ 07094-2977
Phone (201) 392-3100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT191836PAMDTransplant Surgery Physician
256798NYMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Aug 6, 2018 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC Transplant Surgery CurrentSince Aug 6, 2018 Accepting new patients
Metropolitan Medical Practice Plan PC CurrentSince Sep 25, 2017 Accepting new patients
Central Avenue Professional Services, PC CurrentSince Nov 10, 2018 Accepting new patients
Evidence Based Surgery, LLC CurrentSince Sep 1, 2021 Accepting new patients

Locations

1100 Clifton Ave
Clifton, NJ 07013
Phone (973) 777-7879

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

111 Central Ave
Newark, NJ 07102
Phone (973) 877-5060

1901 1st Ave
New York, NY 10029
Phone (212) 230-6262

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD
  • Direct secure messaging: vasileios.kostaras@direct.hackensackmeridian.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345507200000",
    "number": "1144487968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NICOLLS ROAD",
            "address_2": "HSC 19",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948191",
            "telephone_number": "631-444-1791",
            "fax_number": "631-444-7689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NICOLLS ROAD",
            "address_2": "HSC 19",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948191",
            "telephone_number": "631-444-1791",
            "fax_number": "631-444-7689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTARAS",
        "first_name": "VASILEIOS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-20",
        "last_updated": "2012-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "256798",
            "primary": true
        },
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "PA",
            "license": "MT191836",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VASILEIOS",
            "last_name": "KOSTARAS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.