Organization Active NPI

Ronald a Stevens MD, PC

  • Cardiovascular Disease Physician
  • Mineola, NY
National Provider Identifier
1255653739
Registry record updated Feb 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
209886 Issued in NY
Legal business name
RONALD A STEVENS MD, PC
Practice address
166 E Jericho Tpke
Mineola, NY 11501-2098
Phone
(516) 408-3423
NPI assigned
Feb 24, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2010

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

Authorized official

Name
Ronald A Stevens, MDNPI 1639230758
Title
Owner
Phone
(516) 408-3423

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
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 209886 NY Primary

Addresses

Primary practice location

166 E Jericho Tpke
Mineola, NY 11501-2098

Mailing address

166 E Jericho Tpke
Mineola, NY 11501-2098
Phone (516) 408-3423

Other identifiers 1

IdentifierTypeStateIssuer
01920332MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100226000554 NY Part B Supplier - Clinic/Group Practice 6901941137 Receives reassigned benefits from 1 practitioner
Practice locations: Mineola, NY

National Provider Directory

National Provider Directory

Locations

22 Jericho Tpke
Ste 105
Mineola, NY 11501
Phone (516) 294-1100

22 Jericho Tpke
Ste 1
Mineola, NY 11501

166 E Jericho Tpke
Mineola, NY 11501
Phone (516) 294-1100

166 E Jericho Tpke
Ste 10
Mineola, NY 11501
Phone (516) 294-1100

22 S Maryland Ave
Prt Washingtn, NY 11050
Phone (516) 626-7583

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1266969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266969600000",
    "number": "1255653739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 E JERICHO TPKE",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115012098",
            "telephone_number": "516-408-3423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 E JERICHO TPKE",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115012098",
            "telephone_number": "516-408-3423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD A STEVENS MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-24",
        "last_updated": "2010-02-24",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-408-3423",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "209886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01920332",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2010; 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.