NPIMap

Individual provider Active NPI

Sutthichai Sae-Tia, M.D.

  • Infectious Disease Physician
  • Stony Brook, NY
National Provider Identifier
1255541231
Registry record updated Jan 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
296437 Issued in NY
Practice address
Health Sciences Tower Level 17 RM 080 101 Nicolls Road
Stony Brook, NY 11794-1300
Phone
(631) 638-2695
Fax
(631) 444-7518
NPI assigned
May 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 296437 NY Primary
Infectious Disease Physician 207RI0200X MT181140 PA

Addresses

Primary practice location

Health Sciences Tower Level 17 RM 080 101 Nicolls Road
Stony Brook, NY 11794-1300

Mailing address

PO Box 1559
Stony Brook, NY 11790-0989

Other practice location 1

5200 Centre Ave
Ste 203
Pittsburgh, PA 15232-1300
Phone (412) 578-9747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181214000889 NY Practitioner - Infectious Disease 8325113376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-1560

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-1560

205 N Belle Mead Rd
East Setauket, NY 11733-3483
Phone (631) 444-4630

26 Research Way
East Setauket, NY 11733-3526
Phone (631) 444-0580

Lauterbur Dr
Stony Brook, NY 11794-0001
Phone (632) 638-1000

PO Box
Suite 1554
Stony Brook, NY 11790-0989

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT181140PAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Internists, University Faculty Practice Corporation Infectious Disease CurrentSince Dec 30, 2018 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Current Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Dec 30, 2018 Accepting new patients
University Hospital at Stony Brook Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

205 N Belle Mead Rd
Setauket, NY 11733
Phone (631) 444-1660

100 Nicolls Rd
#13202
Stony Brook, NY 11794

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: sutthichai.saetia@direct.stonybrookmedicine.edu

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548720000000",
    "number": "1255541231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900989",
            "fax_number": "631-444-7518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HEALTH SCIENCES TOWER LEVEL 17 RM 080 101 NICOLLS ROAD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117941300",
            "telephone_number": "631-638-2695",
            "fax_number": "631-444-7518"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5200 Centre Ave",
            "address_2": "Ste 203",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152321300",
            "country_code": "US",
            "telephone_number": "412-578-9747",
            "fax_number": "412-788-0250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAE-TIA",
        "first_name": "SUTTHICHAI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2019-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NY",
            "license": "296437",
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "PA",
            "license": "MT181140",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.