Organization Active NPI

Stony Brook Internists, University Faculty Practice Corporation

  • Medical Oncology Physician
  • Stony Brook, NY
National Provider Identifier
1184679342
Registry record updated Nov 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
Legal business name
STONY BROOK INTERNISTS, UNIVERSITY FACULTY PRACTICE CORPORATION
Practice address
Suny @ Stony Brook
HSC, L16, RM 020
Stony Brook, NY 11794-0001
Phone
(631) 444-2448
NPI assigned
May 24, 2006
Last updated
Nov 21, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
STONY BROOK INTERNISTS, UNIVERSITY FACULTY PRACTICE CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 21, 2013

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

Authorized official

Name
Dr. Vincent Yang, MD, PHDNPI 1588676373
Title
Chair Person
Phone
(631) 444-2448

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X Primary

Addresses

Primary practice location

Suny @ Stony Brook
HSC, L16, RM 020
Stony Brook, NY 11794-0001

Mailing address

PO Box 1554
Stony Brook, NY 11790-0988
Phone (631) 444-2448

Other identifiers 2

IdentifierTypeStateIssuer
00615265MedicaidNY
CB8937OtherNYRAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040317000450 NY Part B Supplier - Clinic/Group Practice 9133019821 Receives reassigned benefits from 203 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Stony Brook, NY; Southampton, NY; Smithtown, NY; Saint James, NY; Hauppauge, NY; Rocky Point, NY; Riverhead, NY; Port Jefferson Station, NY…

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Harold Carlson

Locations (25 of 62)

7813 Mitchell Blvd
Ste 111
New Port Richey, FL 34655
Phone (727) 372-2020

600 Main St
Ste B
Center Moriches, NY 11934
Phone (631) 444-7875

200 Pantigo Pl
East Hampton, NY 11937
Phone (631) 329-8630

269 E Main St
East Islip, NY 11730
Phone (631) 312-3493

200 N Belle Mead Rd
East Setauket, NY 11733
Phone (516) 246-9501

3 Technology Dr
Ste 300
East Setauket, NY 11733
Phone (631) 444-5220

3 Technology Dr
Ste 700
East Setauket, NY 11733
Phone (631) 444-5220

4 Technology Dr
Ste 130
East Setauket, NY 11733
Phone (631) 479-3743

45 Research Way
Ste 204
East Setauket, NY 11733
Phone (631) 444-3006

45 Research Way
Ste 208A
East Setauket, NY 11733

850 Fulton St
Ste 4
Farmingdale, NY 11735
Phone (516) 454-8525

225 Community Dr
Ste 160
Great Neck, NY 11021
Phone (516) 482-4790

183 W Montauk Hwy
Hampton Bays, NY 11946
Phone (631) 723-2225

200 Motor Pkwy
Bldg C
Hauppauge, NY 11788

4 Smith Haven Mall
Ste 203
Lake Grove, NY 11755
Phone (631) 444-0561

4 Smith Haven Mall
Ste 203-A
Lake Grove, NY 11755

1741 N Ocean Ave
Medford, NY 11763

1741 N Ocean Ave
Ste A
Medford, NY 11763

1741 N Ocean Ave
Ste D
Medford, NY 11763
Phone (631) 374-7665

43 Radio Ave
Miller Place, NY 11764
Phone (631) 821-4638

625 Belle Terre Rd
Ste 207
Port Jefferson, NY 11777

18 Roosevelt Ave
Port Jefferson Station, NY 11776
Phone (631) 928-2233

815 Hallock Ave
Ste 2
Port Jefferson Station, NY 11776

70 N Country Rd
Ste 101
Prt Jefferson, NY 11777
Phone (631) 473-0037

47 Commerce Ave
Riverhead, NY 11901
Phone (631) 905-0666

Practitioners & affiliated clinicians

Practitioners 372

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 372

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384992000000",
    "number": "1184679342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1554",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900988",
            "telephone_number": "631-444-2448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SUNY @ STONY BROOK",
            "address_2": "HSC, L16, RM 020",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-444-2448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONY BROOK INTERNISTS, UNIVERSITY FACULTY PRACTICE CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STONY BROOK INTERNISTS, UNIVERSITY FACULTY PRACTICE CORPORATION",
        "enumeration_date": "2006-05-24",
        "last_updated": "2013-11-21",
        "status": "A",
        "authorized_official_last_name": "YANG",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_title_or_position": "CHAIR PERSON",
        "authorized_official_telephone_number": "631-444-2448",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00615265",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "CB8937",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.