Mathew D Ednick, D.O.

Primary specialty

Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X

License

34-008778 Issued in OH

Practice address

100 Nicolls Rd # Level11
Stony Brook, NY 11794-8111

Phone

(631) 444-8340

Fax

(631) 444-6045

NPI assigned

May 17, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: mathew.ednick@direct.stonybrookmedicine.edu

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.

• Stony Brook Children'S Service, University Faculty Practice Corporatio

  • Pediatrics Physician
  • Stony Brook, NY
  • NPI 1083660575
  Medicare reassignment
• Stony Brook Surgical Associates, University Faculty Practice Corporati

  • Surgery Physician
  • Stony Brook, NY
  • NPI 1063468536
  NPD (past)
• University Physicians of Brooklyn, Inc.

  • Pediatrics Physician
  • Brooklyn, NY
  • NPI 1649227190

  Pediatric Pulmonology

  NPD (past)

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385510400000",
    "number": "1295942266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900989",
            "telephone_number": "631-444-8340",
            "fax_number": "631-444-6045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NICOLLS RD # LEVEL11",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948111",
            "telephone_number": "631-444-8340",
            "fax_number": "631-444-6045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDNICK",
        "first_name": "MATHEW",
        "middle_name": "D",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2013-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "OH",
            "license": "34-008778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• East Billow Acupuncture, P.C.
• Eastern Medical Care of Suffolk County, P.C.
• Madeline Eckhardt
• Christopher Edelstein, RPA
• Rivcka Edelstein, PHD
• Liam Jacob Edwards-Gaherty, MD, MPH
• Pember Bates Edwards, DDS
• Navid Eghbali, DDS
• Martin Henry Ehrlich, MD
• Arash Ehteshami Afshar, M.D, MSC

• Pediatric Pulmonology Physician in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Pediatric Pulmonology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.