Active NPI
Matthew James Stiller, M.D.
- Dermatology Physician
- New Rochelle, NY
National Provider Identifier
1275828741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 131336-1
- Practice address
- 148 Daisy Farms Dr.
New Rochelle, NY 10804-1034 - Phone
- (914) 632-4528
- NPI assigned
- Jun 13, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 131336-1 | NY | Primary |
Addresses
Primary practice location
148 Daisy Farms Dr.
New Rochelle, NY 10804-1034
Mailing address
148 Daisy Farms Dr
New Rochelle, NY 10804-1034
Phone (914) 632-4528
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 131336-1 | NY | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307923200000",
"number": "1275828741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "148 DAISY FARMS DR",
"city": "NEW ROCHELLE",
"state": "NY",
"postal_code": "108041034",
"telephone_number": "914-632-4528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "148 DAISY FARMS DR.",
"city": "NEW ROCHELLE",
"state": "NY",
"postal_code": "108041034",
"telephone_number": "914-632-4528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STILLER",
"first_name": "MATTHEW",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-13",
"last_updated": "2011-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NY",
"license": "131336-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Rochelle, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.