Stony Brook Orthopaedic Associates, University Faculty Practice Corpor
Organization Active NPI Orthopaedic Surgery Physician · Stony Brook, NY
NPI 1154377638 · NPPES record last updated Dec 11, 2014
Key facts
- NPI
- 1154377638
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- Legal business name
- STONY BROOK ORTHOPAEDIC ASSOCIATES, UNIVERSITY FACULTY PRACTICE CORPOR
- Practice address
- Suny @ Stony Brook
HSC, L18, RM 080
Stony Brook, NY 11794-0001 - Phone
- (631) 444-1478
- NPI assigned
- May 26, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Lawrence Hurst, M.D.
- Title
- Chair Person
- Phone
- (631) 444-1478
Practitioners 94
-
James Michael Barsi, M.D.
-
Jason Robert Behar, D.P.M
-
Nestor D Blyznak, MD
-
Stuart B. Cherney, M.D.
-
Brian Cruickshank, M.D.
-
Michael Doany, MD
-
Kristin Twomey Hopkins, M.D.
-
Sandra Joan Iannotti, M.D.
-
Fazel A Khan, M.D.
-
Seth Korbin, MD
-
Stephen Kottmeier, M.D.
-
Brian Christopher Lynch, M.D.
-
Daren J McCalla, MD
-
Cris J Min, MD
-
Samantha Ilana Muhlrad, M.D.
-
James Nicholson, M.D.
-
Benson Go Onghai, M.D.
-
Megan Carroll Paulus, M.D.
-
James Penna, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040313000223 | NY | Part B Supplier - Clinic/Group Practice | 7810886231 |
Receives reassigned benefits from 56 practitioners Practice locations: East Setauket, NY; Stony Brook, NY; Southampton, NY; Smithtown, NY; Riverhead, NY; Port Jefferson, NY; Mattituck, NY; Lake Grove, NY… |
| O20111118000404 | NY | DME Supplier - Physician - General Practice | 7810886231 | Practice locations: Lake Grove, NY |
National Provider Directory
Locations
500 Commack Rd
Unit 100
Commack, NY 11725
Phone (631) 221-6818
14 Technology Dr
Ste 12
East Setauket, NY 11733
Phone (631) 444-7979
182 W Montauk Hwy
Ste C
Hampton Bays, NY 11946
Phone (631) 353-7810
240B W Montauk Hwy
Hampton Bays, NY 11946
Phone (631) 728-7400
Univ Hspl5
Rm 048
Stony Brook, NY 11794
1320 Stony Brook Rd
Ste G
Stony Brook, NY 11790
101 Nicolls Rd
Rm 80
Stony Brook, NY 11794
Phone (631) 383-7828
1 Lauterbur Dr
Stony Brook, NY 11794
Phone (408) 828-3211
100 Nicolls Rd
Rm 80T18
Stony Brook, NY 11794
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician |
207X00000X | Yes |
Addresses
Primary practice location
Suny @ Stony Brook
HSC, L18, RM 080
Stony Brook, NY 11794-0001
Mailing address
PO Box 1554
Stony Brook, NY 11790-0988
Phone (631) 444-1478
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00693783 | Medicaid | NY |
Other providers in Stony Brook, NY
- Stony Brook Medical Center
- Stony Brook Occupational Therapy
- Stony Brook Ophthalmology, University Faculty Practice Corporation
- Stony Brook Opticians Inc
- Stony Brook Oral and Facial Surgery PC
- Stony Brook Pathologists, University Faculty Practice Corporation
- Stony Brook Pharmacy
- Stony Brook Preventive Medicine Services, Univ Fclty Practice Corp
- Stony Brook Psychiatric Associates, University Faculty Practice Corpor
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All providers in Stony Brook, NY · Orthopaedic Surgery Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 11, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.