NPIMap

Organization Active NPI

Stony Brook Internists, University Faculty Practice Corporation

  • Cardiac Rehabilitation Registered Nurse
  • Stony Brook, NY
National Provider Identifier
1295778371
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiac Rehabilitation Registered NurseTaxonomy code 163WC3500X
Legal business name
STONY BROOK INTERNISTS, UNIVERSITY FACULTY PRACTICE CORPORATION
Practice address
Suny @ Stony Brook
HSC, L16, RM 020
Stony Brook, NY 11794-0001
Phone
(631) 444-2448
NPI assigned
Jun 14, 2006
Last updated
Jul 28, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
STONY BROOK INTERNISTS, UNIVERSITY FACULTY PRACTICE CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Authorized official

Name
Dr. Vincent Yang, M.D.,PHD
Title
Chair Person
Phone
(631) 444-2448

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiac Rehabilitation Registered Nurse 163WC3500X NU Primary
Cardiovascular Disease Physician 207RC0000X NU

Addresses

Primary practice location

Suny @ Stony Brook
HSC, L16, RM 020
Stony Brook, NY 11794-0001

Mailing address

PO Box 1554
Stony Brook, NY 11790-0988
Phone (631) 444-2448

Other identifiers 2

IdentifierTypeStateIssuer
00615265MedicaidNY
CB8937OtherNYRAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040317000450 NY Part B Supplier - Clinic/Group Practice 9133019821 Receives reassigned benefits from 203 practitioners
2 other NPIs on this enrollment
Practice locations: Stony Brook, NY; Southampton, NY; Smithtown, NY; Saint James, NY; Hauppauge, NY; Rocky Point, NY; Riverhead, NY; Port Jefferson Station, NY…
O20230201001849 NY Part B Supplier - Intensive Cardiac Rehabilitation 9133019821 Receives reassigned benefits from 15 practitioners
Practice locations: East Setauket, NY

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Haldun C Mutlu

Locations

600 Main St
Ste B
Center Moriches, NY 11934
Phone (631) 444-7875

500 Commack Rd
Ste 103
Commack, NY 11725
Phone (631) 638-0160

200 Pantigo Pl
Ste N
East Hampton, NY 11937
Phone (631) 329-6500

492 Montauk Hwy
East Moriches, NY 11940
Phone (631) 638-2900

140 N Belle Mead Ave
East Setauket, NY 11733
Phone (631) 446-4686

3 Technology Dr
East Setauket, NY 11733
Phone (631) 444-5220

4 Technology Dr
Ste 140
East Setauket, NY 11733

45 Research Way
Ste 106
East Setauket, NY 11733

1600 Brecknock Rd
Greenport, NY 11944
Phone (631) 477-3800

34 E Montauk Hwy
Ste 1
Hampton Bays, NY 11946
Phone (631) 702-8900

200 Motor Pkwy
Ste 16
Hauppauge, NY 11788
Phone (631) 444-9600

200 Motor Pkwy
Ste C16
Hauppauge, NY 11788
Phone (631) 638-4933

4 Smith Haven Mall
Ste 203
Lake Grove, NY 11755
Phone (631) 444-0561

1741 N Ocean Ave
Ste A
Medford, NY 11763

3003 New Hyde Park Rd
North New Hyde Pk, NY 11042
Phone (516) 327-0001

47 Commerce Ave
Ste 1
Riverhead, NY 11901
Phone (631) 978-7633

745 Route 25A
Ste F
Rocky Point, NY 11778

24 Research Way
Setauket, NY 11733
Phone (631) 444-4666

2000 Bishops Rd
Smithtown, NY 11787
Phone (631) 418-8069

732 Smithtown Byp
Smithtown, NY 11787
Phone (631) 320-1070

676 County Road 39A
Southampton, NY 11968
Phone (631) 283-2070

1320 Stony Brook Rd
Bldg D100
Stony Brook, NY 11790
Phone (631) 941-2273

Practitioners & affiliated clinicians

Practitioners 517

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 517

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690502400000",
    "number": "1295778371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1554",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900988",
            "telephone_number": "631-444-2448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SUNY @ STONY BROOK",
            "address_2": "HSC, L16, RM 020",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-444-2448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONY BROOK INTERNISTS, UNIVERSITY FACULTY PRACTICE CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STONY BROOK INTERNISTS, UNIVERSITY FACULTY PRACTICE CORPORATION",
        "enumeration_date": "2006-06-14",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A",
        "authorized_official_last_name": "YANG",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_title_or_position": "CHAIR PERSON",
        "authorized_official_telephone_number": "631-444-2448",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D.,PHD"
    },
    "taxonomies": [
        {
            "code": "163WC3500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Cardiac Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00615265",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "CB8937",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "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 Jul 28, 2023; 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.