David Daniel Stark, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

219922 Issued in NY

Practice address

19 Homeward LN
Montauk, NY 11954-5295

Phone

(212) 969-9096

NPI assigned

Apr 4, 2007

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

Enrolled in NY

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• University Physicians of Brooklyn, Inc.

  • Diagnostic Radiology Physician
  • Brooklyn, NY
  • NPI 1376590828
  NPD (past)
• Dedham MRI Inc

  • Radiology Clinic/Center
  • Dedham, MA
  • NPI 1760400204

  Diagnostic Radiology

  NPD (past)

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1194847665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 E DILIDO DR",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331391229",
            "telephone_number": "212-969-9096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 HOMEWARD LN",
            "city": "MONTAUK",
            "state": "NY",
            "postal_code": "119545295",
            "telephone_number": "212-969-9096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "DAVID",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "52224",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "219922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meghan Anne Ryan, DPT
• Stefanie Sacks Dec, M.S., C.N.S, C.D.N
• Jacob Aaron Sadavoy, BCBA
• Sarah Schroetter, DDS
• Bettina N Schuler, L.AC.
• Maggie Sweeney
• Michael Tenore, DO
• Daniel Michael Vasti, DDS
• Lori I Wolfe, OTR

• Internal Medicine Physician in Montauk, NY
• Providers in Montauk, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.