Individual provider Active NPI

Stefan Thomas Rau, M.D.

  • Diagnostic Radiology Physician
  • Ellenville, NY
National Provider Identifier
1275770950
Registry record updated Sep 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
257634 Issued in NY
Practice address
10 Healthy Way
Ellenville Regional Hospital- Radiology Dept
Ellenville, NY 12428
Phone
(845) 647-6400
NPI assigned
Jan 16, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 257634 NY Primary

Addresses

Primary practice location

10 Healthy Way
Ellenville Regional Hospital- Radiology Dept
Ellenville, NY 12428

Mailing address

10 Healthy Way
Ellenville Regional Hospital- Radiology Dept
Ellenville, NY 12428-5612
Phone (267) 257-9213

Other practice location 1

80 Seymour St
Hartford Hospital Department of Radiology
Hartford, CT 06102-8000
Phone (860) 545-2864

Other identifiers 1

IdentifierTypeStateIssuer
03249929MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101117001537 NY Practitioner - Diagnostic Radiology 4082767751 Reassigns benefits to 1 organization
I20220630001916 PA Practitioner - Diagnostic Radiology 4082767751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Temple University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Millennium Medical Imaging PCGroup PAC ID 5799776910, 34 clinicians

Practice addresses (Care Compare)

169 Riveride Dr
Binghamton, NY 13905-4246
Phone (607) 798-5111

17 Chenango Bridge Rd
Binghamton, NY 13901-1233
Phone (607) 772-2995

203 Old Military Rd
Lake Placid, NY 12946-1738
Phone (518) 650-7503

211 Church St
Saratoga Springs, NY 12866-1003
Phone (518) 583-8461

2233 State Route 86
Saranac Lake, NY 12983-5644
Phone (518) 897-2317

240 Riverside Dr
Johnson City, NY 13790-2727
Phone (518) 650-7503

276 -280 Robinson St
Binghamton, NY 13904-1659
Phone (607) 771-7234

3040 Route 50
Saratoga Springs, NY 12866-3073
Phone (518) 650-7503

3101 Shippers Rd
Vestal, NY 13850-2080
Phone (607) 786-4822

39 E Main St
Hancock, NY 13783-1128
Phone (607) 637-5700

415 E Main St
Endicott, NY 13760-4925
Phone (607) 785-2460

500 5TH Ave
Owego, NY 13827-1620
Phone (607) 687-1122

6 Medical Park Dr
Malta, NY 12020-5051
Phone (518) 289-2024

6 Medical Park Dr
Suite 204
Ballston Spa, NY 12020-5053
Phone (518) 650-7503

6400 Collamer Rd
East Syracuse, NY 13057-1032
Phone (800) 533-9729

65 Pennsylvania Ave
Binghamton, NY 13903-1651
Phone (607) 723-5393

7 Herbert Dr
Latham, NY 12110-3801
Phone (518) 785-3511

7 Stetson Rd
Tupper Lake, NY 12986-2014
Phone (518) 359-7000

7 Timmerman Ave
St Johnsville, NY 13452-1017
Phone (518) 568-7145

84 E State St
Gloversville, NY 12078-1202
Phone (518) 773-8894

959 Route 9
Suite O
Queensbury, NY 12804-6290
Phone (518) 947-0931

99 E State St
Gloversville, NY 12078-1203
Phone (518) 773-5522

Hospital & facility affiliations

  • Our Lady of Lourdes Memorial Hospital, Inc Hospital, Binghamton, NY, CCN 330011
  • St Marys Healthcare Hospital, Amsterdam, NY, CCN 330047
  • Nathan Littauer Hospital Hospital, Gloversville, NY, CCN 330276
  • Saratoga Hospital Hospital, Saratoga Springs, NY, CCN 330222
  • Adirondack Medical Center - Saranac Lake Hospital, Saranac Lake, NY, CCN 330079

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
257634NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Barnes-Kasson County Hospital CurrentSince Jun 1, 2022 Accepting new patients
Millennium Medical Imaging PC Diagnostic Radiology CurrentSince Aug 15, 2010 Accepting new patients
Barnes-Kasson County Hospital CurrentSince Jun 1, 2022 Accepting new patients
University Imaging Center, LLC Diagnostic Radiology Past Accepting new patients
University Imaging Center, LLC Diagnostic Radiology Past Accepting new patients

Locations

427 Guy Park Ave
Amsterdam, NY 12010
Phone (518) 442-1404

17 Chenango Bridge Rd
Binghamton, NY 13901
Phone (607) 772-2995

65 Pennsylvania Ave
Binghamton, NY 13903
Phone (607) 723-5393

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

6400 Collamer Rd
East Syracuse, NY 13057
Phone (315) 437-1622

10 Healthy Way
Ellenville, NY 12428
Phone 8456476400294

415 E Main St
Endicott, NY 13760
Phone (607) 785-2460

99 E State St
Gloversville, NY 12078
Phone (518) 773-5690

39 E Main St
Hancock, NY 13783
Phone (607) 637-5700

150 Sawkill Rd
Kingston, NY 12401
Phone (845) 339-7700

203 Old Military Rd
Lake Placid, NY 12946
Phone (518) 523-1327

4 Johnson Rd
Latham, NY 12110
Phone (518) 220-2080

7 Herbert Dr
Latham, NY 12110
Phone (518) 785-3511

6 Medical Park Dr
Malta, NY 12020
Phone (518) 289-2020

2388 Route 9
Mechanicville, NY 12118
Phone (518) 587-0845

202 S Central Ave
Mechanicville, NY 12118
Phone (518) 580-2099

2233 State Route 86
Saranac Lake, NY 12983
Phone (518) 891-4141

188 Church St
Saratoga Springs, NY 12866
Phone (516) 650-7503

211 Church St
Saratoga Springs, NY 12866
Phone (518) 583-8461

3040 Route 50
Saratoga Springs, NY 12866
Phone (518) 580-2170

7 Stetson Rd
Tupper Lake, NY 12986
Phone (518) 359-7000

2872 Turnpike St
Susquehanna, PA 18847
Phone (570) 853-3135

Interoperability endpoints

  • Direct secure messaging: srau101887@albanymed.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1232064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538006400000",
    "number": "1275770950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 HEALTHY WAY",
            "address_2": "ELLENVILLE REGIONAL HOSPITAL- RADIOLOGY DEPT",
            "city": "ELLENVILLE",
            "state": "NY",
            "postal_code": "124285612",
            "telephone_number": "267-257-9213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 HEALTHY WAY",
            "address_2": "ELLENVILLE REGIONAL HOSPITAL- RADIOLOGY DEPT",
            "city": "ELLENVILLE",
            "state": "NY",
            "postal_code": "12428",
            "telephone_number": "845-647-6400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Seymour St",
            "address_2": "Hartford Hospital Department of Radiology",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061028000",
            "country_code": "US",
            "telephone_number": "860-545-2864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAU",
        "first_name": "STEFAN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-16",
        "last_updated": "2018-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "257634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03249929",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellenville, NY

Sources for this page

Verify at the official NPI Registry.