Brett Evan Stark, DO

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

0102208242 Issued in VA

Practice address

Naval Health Clinic Patuxent River
47149 Buse Rd BLDG 1370
Patuxent River, MD 20670

Phone

(757) 953-5008

NPI assigned

May 26, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1407594682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NAVAL HEALTH CLINIC PATUXENT RIVER",
            "address_2": "47149 BUSE RD BLDG 1370",
            "city": "PATUXENT RIVER",
            "state": "MD",
            "postal_code": "20670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL HEALTH CLINIC PATUXENT RIVER",
            "address_2": "47149 BUSE RD BLDG 1370",
            "city": "PATUXENT RIVER",
            "state": "MD",
            "postal_code": "20670",
            "telephone_number": "757-953-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "BRETT",
        "middle_name": "EVAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-26",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0102208242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher P. Russell, DPT
• Carl W. Schamu, DMD
• Christopher Joseph Schumacher, PTA
• Anna Maria Sheehan, APN
• Charles Sherman
• Charles T Swail, DO
• Tinsae Tekleab
• Evelyn Tipton
• Marypat Tobola, FNP
• Monika Turner, PHARMD

• General Practice Physician in Patuxent River, MD
• Providers in Patuxent River, MD by specialty
• General Practice Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; 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.