Individual provider Active NPI

Jeremy Michael Hugh, M.D.

  • Dermatology Physician
  • Stony Brook, NY
National Provider Identifier
1427316348
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
314161 Issued in NY
Practice address
1320 Stony Brook Rd
Stony Brook, NY 11790-2206
Phone
(631) 444-4200
Fax
(631) 638-4220
NPI assigned
Apr 28, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 17511 NH
Dermatology Physician 207N00000X DR.00588444 CO
Dermatology Physician 207N00000X 314161 NY Primary

Addresses

Primary practice location

1320 Stony Brook Rd
Stony Brook, NY 11790-2206

Mailing address

1320 Stony Brook Rd
Stony Brook, NY 11790-2206
Phone (631) 444-4200

Other practice location 1

5555 E Arapahoe Rd
Centennial, CO 80122-2312
Phone (303) 338-4545

Other identifiers 2

IdentifierTypeStateIssuer
9000148091MedicaidCO
029226OtherCOKAISER COMMERCIAL NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

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
I20220531001809 NY Practitioner - Dermatology 5698077436 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
New York Medical College, 2012
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

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions380
Removal or shaving of skin growth19
Skin biopsy121

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.00588444COMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Dermatology Associates, University Faculty Practice Corpor Dermatology CurrentSince Jul 1, 2022 Accepting new patients
Stony Brook Pathologists, University Faculty Practice Corporation Past Accepting new patients
The New London Hospital Association, Inc. Past Accepting new patients

Locations

500 Commack Rd
Ste 105
Commack, NY 11725

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

1320 Stony Brook Rd
Stony Brook, NY 11790
Phone (631) 638-0800

1320 Stony Brook Rd
Ste 200
Stony Brook, NY 11790
Phone (631) 444-4272

Networks

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

Organizations & group practices 3

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": "1335571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1427316348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 STONY BROOK RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902206",
            "telephone_number": "631-444-4200",
            "fax_number": "631-638-4220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 STONY BROOK RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902206",
            "telephone_number": "631-444-4200",
            "fax_number": "631-638-4220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5555 E Arapahoe Rd",
            "address_purpose": "LOCATION",
            "city": "Centennial",
            "state": "CO",
            "postal_code": "801222312",
            "country_code": "US",
            "telephone_number": "303-338-4545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUGH",
        "first_name": "JEREMY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-28",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NH",
            "license": "17511",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "DR.00588444",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "314161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000148091",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "029226",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5555 E Arapahoe Rd",
            "city": "Centennial",
            "state": "CO",
            "country_code": "US",
            "postal_code": "801222312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.