Organization Active NPI

Kingston Urological Associates

  • Urology Physician
  • Kingston, NY
National Provider Identifier
1437223153
Registry record updated Feb 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
116375-1 Issued in NY
Legal business name
KINGSTON UROLOGICAL ASSOCIATES
Practice address
40 Hurley Ave
Suite 17
Kingston, NY 12401-3739
Phone
(845) 339-6022
Fax
(845) 339-5467
NPI assigned
Nov 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2016

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

Authorized official

Name
Dr. Thomas V Stellato, M.D.NPI 1548353675
Title
Sole Proprietor
Phone
(845) 339-6022

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X 116375-1 NY Primary

Addresses

Primary practice location

40 Hurley Ave
Suite 17
Kingston, NY 12401-3739

Mailing address

40 Hurley Ave
Suite 17
Kingston, NY 12401-3739
Phone (845) 339-6022

Other identifiers 2

IdentifierTypeStateIssuer
W12501OtherPTAN
01379157MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070131000487 NY Part B Supplier - Clinic/Group Practice 1658260070 Receives reassigned benefits from 1 practitioner
Practice locations: Kingston, NY

National Provider Directory

National Provider Directory

Locations

40 Hurley Ave
Ste 17
Kingston, NY 12401
Phone (845) 338-3212

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455235200000",
    "number": "1437223153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 HURLEY AVE",
            "address_2": "SUITE 17",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013739",
            "telephone_number": "845-339-6022",
            "fax_number": "845-339-5467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 HURLEY AVE",
            "address_2": "SUITE 17",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013739",
            "telephone_number": "845-339-6022",
            "fax_number": "845-339-5467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGSTON UROLOGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2016-02-12",
        "status": "A",
        "authorized_official_last_name": "STELLATO",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "845-339-6022",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "NY",
            "license": "116375-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "W12501",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01379157",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.