Individual provider Active NPI

Robert Stall, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Getzville, NY
National Provider Identifier
1205822202
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
163872-1 Issued in NY
Practice address
97 King Anthony Way
Getzville, NY 14068-1413
Phone
(716) 861-1312
Fax
(888) 976-5853
NPI assigned
Sep 25, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 163872-1 NY Primary

Addresses

Primary practice location

97 King Anthony Way
Getzville, NY 14068-1413

Mailing address

97 King Anthony Way
Getzville, NY 14068-1413
Phone (716) 861-1312

Other identifiers 1

IdentifierTypeStateIssuer
01207083-2MedicaidNY

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
I20080505000367 NY Practitioner - Geriatric MedicinePractitioner - Internal Medicine 5496834343 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
163872-1NYMDGeriatric Medicine (Internal Medicine) Physician

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1127606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1205822202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 KING ANTHONY WAY",
            "city": "GETZVILLE",
            "state": "NY",
            "postal_code": "140681413",
            "telephone_number": "716-861-1312",
            "fax_number": "888-976-5853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 KING ANTHONY WAY",
            "city": "GETZVILLE",
            "state": "NY",
            "postal_code": "140681413",
            "telephone_number": "716-861-1312",
            "fax_number": "888-976-5853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALL",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-25",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "163872-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01207083-2",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Getzville, NY

Sources for this page

Verify at the official NPI Registry.