Active NPI
Jeremy Fertel, MD
- Cardiovascular Disease Physician
- Stony Brook, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 307344-01
- Practice address
- 1320 Stony Brook Rd Ste 100
Stony Brook, NY 11790-2222 - Phone
- (631) 941-2273
- NPI assigned
- Apr 13, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Cardiovascular Disease Physician | 207RC0000X | 307344-01 | NY | Primary |
Addresses
Primary practice location
1320 Stony Brook Rd Ste 100
Stony Brook, NY 11790-2222
Mailing address
1320 Stony Brook Rd Ste 100
Stony Brook, NY 11790-2222
Phone (631) 941-2273
Other practice location 1
111 E 210th St
Bronx, NY 10467-2401
Phone (718) 920-4321
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jeremy.fertal@sbcm.cernerdirect.com |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
26 Research Way
East Setauket, NY 11733-3526
Phone (631) 444-0580
301 E Main St
Bay Shore, NY 11706-8408
Phone (631) 941-2000
Hospital & facility affiliations
- Suny/Stony Brook University Hospital
- John T Mather Memorial Hospital of Port Jefferson
- St Charles Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 307344-01 | NY | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cardiac Ekg Interpretation, P. C. | Cardiovascular Disease | Current | Accepting new patients |
| Stony Brook Internists, University Faculty Practice Corporation | Cardiovascular Disease | Current | Accepting new patients |
| Stony Brook Internists, University Faculty Practice Corporation | Past | Accepting new patients |
Locations
301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977
26 Research Way
East Setauket, NY 11733
Phone (631) 444-0502
200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000
1320 Stony Brook Rd
Ste 100
Stony Brook, NY 11790
Phone (631) 941-2273
1320 Stony Brook Rd
Bldg D100
Stony Brook, NY 11790
Phone (631) 941-2273
1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
Interoperability endpoints
- jeremy.fertal@sbcm.cernerdirect.com
Organizations & group practices 3
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.
-
- Cardiac Rehabilitation Registered Nurse
- Stony Brook, NY
- NPI 1295778371
Cardiovascular Disease
-
- Cardiovascular Disease Physician
- West Islip, NY
- NPI 1386665644
-
- Medical Oncology Physician
- Stony Brook, NY
- NPI 1184679342
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Port Jefferson, NY
- NPI 1093718728
-
- General Acute Care Hospital
- Port Jefferson, NY
- NPI 1164481529
-
- General Acute Care Hospital
- Southampton, NY
- NPI 1033224704
-
- General Acute Care Hospital
- Southampton, NY
- NPI 1225507114
-
- General Acute Care Hospital
- Greenport, NY
- NPI 1881690691
-
- General Acute Care Hospital
- Stony Brook, NY
- NPI 1972523348
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633996800000",
"number": "1285020628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1320 STONY BROOK RD STE 100",
"city": "STONY BROOK",
"state": "NY",
"postal_code": "117902222",
"telephone_number": "631-941-2273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 STONY BROOK RD STE 100",
"city": "STONY BROOK",
"state": "NY",
"postal_code": "117902222",
"telephone_number": "631-941-2273"
}
],
"practiceLocations": [
{
"address_1": "111 E 210th St",
"address_purpose": "LOCATION",
"city": "Bronx",
"state": "NY",
"postal_code": "104672401",
"country_code": "US",
"telephone_number": "718-920-4321",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FERTEL",
"first_name": "JEREMY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-04-13",
"last_updated": "2021-10-12",
"certification_date": "2021-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "NY",
"license": "307344-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jeremy.fertal@sbcm.cernerdirect.com",
"affiliation": "N",
"address_1": "1320 Stony Brook Rd Ste 100",
"city": "Stony Brook",
"state": "NY",
"country_code": "US",
"postal_code": "117902222",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Stony Brook, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.