Individual provider Active NPI

Stephen Vitkun, M.D.

  • Anesthesiology Physician
  • Stony Brook, NY
National Provider Identifier
1356378913
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
157610 Issued in NY
Practice address
Health Sciences Center L4 #060
Stony Brook, NY 11794-0001
Phone
(631) 444-2975
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 157610 NY Primary

Addresses

Primary practice location

Health Sciences Center L4 #060
Stony Brook, NY 11794-0001

Mailing address

PO Box 1559
Stony Brook, NY 11790-0989
Phone (631) 444-2975

Other identifiers 2

IdentifierTypeStateIssuer
01018139MedicaidNY
32B081OtherNYEMPIRE BC.BS

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
I20100310000355 NY Practitioner - Anesthesiology 0345243960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Geisel School of Medicine at Dartmouth, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-8480
Phone (631) 444-2975

201 Manor PL
Greenport, NY 11944-1222
Phone (631) 444-2975

3 Edmund D Pellegrino Rd
Stony Brook, NY 11794-0001
Phone (631) 638-0800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
157610NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Anaesthesiology, University Faculty Practice Corporation Anesthesiology CurrentSince May 30, 2010 Accepting new patients

Locations

201 Manor Pl
Greenport, NY 11944
Phone (631) 477-1000

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Interoperability endpoints

  • Direct secure messaging: stephen.vitkun@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 and National Provider Directory roles.

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356378913",
    "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": "631-444-2975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HEALTH SCIENCES CENTER L4 #060",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-444-2975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITKUN",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "157610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01018139",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC.BS",
            "identifier": "32B081",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.