Individual provider Active NPI

Stuart Gerald Selkin, MD JD

  • Otolaryngology Physician
  • Melville, NY
National Provider Identifier
1205052180
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD 098873 Issued in NY
Practice address
801 Walt Whitman Road
Melville, NY 11747
Phone
(631) 692-7362
Fax
(631) 692-7546
NPI assigned
Apr 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD 098873 NY Primary

Addresses

Primary practice location

801 Walt Whitman Road
Melville, NY 11747

Mailing address

801 Walt Whitman Road
Melville, NY 11747
Phone (631) 692-7362

Other identifiers 1

IdentifierTypeStateIssuer
WCB 222483OtherNYWORKMANS COMP

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040916000677 NY Practitioner - Otolaryngology 4183691215 Practice locations: Melville, NY

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
State University of New York Downstate Medical Center, 1966
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

801 Walt Whitman Rd
Melville, NY 11747-2208
Phone (631) 692-7362

801 Walt Whitman Rd
Suite 1
Melville, NY 11747-2218

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Juris Doctor, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD 098873NYMDOtolaryngology Physician

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205052180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 WALT WHITMAN ROAD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "11747",
            "telephone_number": "631-692-7362",
            "fax_number": "631-692-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 WALT WHITMAN ROAD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "11747",
            "telephone_number": "631-692-7362",
            "fax_number": "631-692-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELKIN",
        "first_name": "STUART",
        "middle_name": "GERALD",
        "credential": "MD JD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "MD 098873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKMANS COMP",
            "identifier": "WCB 222483",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melville, NY

Sources for this page

Verify at the official NPI Registry.