Individual provider Active NPI

Jordan Barry Slutsky, MD

  • MOHS-Micrographic Surgery Physician
  • Stony Brook, NY
National Provider Identifier
1336309848
Registry record updated May 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
268804-1 Issued in NY
Practice address
Stony Brook University Hospital
Medical Staff Office
Stony Brook, NY 11794-7148
Phone
(631) 444-2754
Fax
(631) 444-6031
NPI assigned
Jun 10, 2008
Last updated
May 13, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X 268804-1 NY Primary

Addresses

Primary practice location

Stony Brook University Hospital
Medical Staff Office
Stony Brook, NY 11794-7148

Mailing address

Stony Brook University Hospital
Medical Staff Office
Stony Brook, NY 11794-7148
Phone (631) 444-2754

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130807000894 NY Practitioner - Micrographic Dermatologic Surgery (MDS)Practitioner - Dermatology 6800065368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Micrographic Dermatologic Surgery (MDS)Also: Dermatology
Education
State University of New York at Stony Brook, School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1320 Stony Brook Rd
Suite 200
Stony Brook, NY 11790-2215
Phone (631) 444-4200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision115
Removal of tissue1-10
Removal of skin lesions82
Removal of skin cancer711
Removal of nail tissue1-10
Removal or shaving of skin growth16
Skin biopsy11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
268804-1NYMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Dermatology Associates, University Faculty Practice Corpor CurrentSince Aug 1, 2013 Accepting new patients

Locations

1320 Stony Brook Rd
Bldg F200
Stony Brook, NY 11790
Phone (631) 444-3843

Networks

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

Interoperability endpoints

  • Direct secure messaging: jordan.slutsky@direct.stonybrookmedicine.edu

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368403200000",
    "number": "1336309848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "STONY BROOK UNIVERSITY HOSPITAL",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117947148",
            "telephone_number": "631-444-2754",
            "fax_number": "631-444-6031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STONY BROOK UNIVERSITY HOSPITAL",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117947148",
            "telephone_number": "631-444-2754",
            "fax_number": "631-444-6031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLUTSKY",
        "first_name": "JORDAN",
        "middle_name": "BARRY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-10",
        "last_updated": "2013-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NY",
            "license": "268804-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.