NPIMap

Individual provider Active NPI

Ken-Michael S Bayle, D.O.

  • Pediatric Cardiology Physician
  • Stony Brook, NY
National Provider Identifier
1356683437
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
298863 Issued in NY
Practice address
Stony Brook University Hospital
Department of Pediatrics HSC T-11 / 040
Stony Brook, NY 11794-2894
Phone
(631) 444-2020
Fax
(631) 444-2894
NPI assigned
Mar 26, 2013
Last updated
Aug 24, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 298863 NY
Pediatric Cardiology Physician 2080P0202X 298863 NY Primary

Addresses

Primary practice location

Stony Brook University Hospital
Department of Pediatrics HSC T-11 / 040
Stony Brook, NY 11794-2894

Mailing address

101 Nicolls Rd
HSC Floor 11 RM 20
Stony Brook, NY 11794-8111

Other practice location 1

5645 Main St
Flushing, NY 11355-5045
Phone (718) 670-2468

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190617000379 NY Practitioner - Pediatric Medicine 2567795040 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-3407
Phone (631) 444-7653

2701 Sunrise Hwy
Islip Terrace, NY 11752-2642
Phone (631) 638-2375

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
298863NYMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York Queens Medicine and Surgery, P.C. Pediatrics CurrentSince Jul 15, 2019 Accepting new patients
Stony Brook Children's Service, University Faculty Practice Corporatio Pediatrics CurrentSince Aug 1, 2022 Accepting new patients
Weill Medical College of Cornell Pediatrics Current Accepting new patients
Weill Medical College of Cornell CurrentSince Jul 15, 2019 Accepting new patients
Stony Brook Radiology, University Faculty Practice Corporation CurrentSince Sep 1, 2025 Accepting new patients
Weill Medical College of Cornell Pediatrics CurrentSince Jul 15, 2019 Accepting new patients
New York Queens Medicine and Surgery, P.C. CurrentSince Jul 15, 2019 Accepting new patients

Locations

269 E Main St
East Islip, NY 11730
Phone (631) 312-3493

5645 Main St
Flushing, NY 11355
Phone (718) 670-1435

16303 Horace Harding Expy
Fl 2
Fresh Meadows, NY 11365
Phone (718) 888-9121

2701 Sunrise Hwy
Islip Terrace, NY 11752
Phone (631) 444-6300

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

525 E 68th St
#M6
New York, NY 10065
Phone (212) 746-3558

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

Networks

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

Interoperability endpoints

  • Direct secure messaging: ksb9010@direct.nyp.org

Organizations & group practices 7

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": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1356683437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NICOLLS RD",
            "address_2": "HSC FLOOR 11 RM 20",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STONY BROOK UNIVERSITY HOSPITAL",
            "address_2": "DEPARTMENT OF PEDIATRICS HSC T-11 / 040",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117942894",
            "telephone_number": "631-444-2020",
            "fax_number": "631-444-2894"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5645 Main St",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113555045",
            "country_code": "US",
            "telephone_number": "718-670-2468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAYLE",
        "first_name": "KEN-MICHAEL",
        "middle_name": "S",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-26",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "298863",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NY",
            "license": "298863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.