Individual provider Active NPI

Jared Ian Seltzer

  • Student in an Organized Health Care Education/Training Program
  • Stony Brook, NY
National Provider Identifier
1457515660
Registry record updated Jul 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
Medical House Staff Office
Stony Brook Univeristy Hospital
Stony Brook, NY 11794-7148
Phone
(631) 444-2754
Fax
(631) 444-6031
NPI assigned
Jul 16, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

Medical House Staff Office
Stony Brook Univeristy Hospital
Stony Brook, NY 11794-7148

Mailing address

Medical House Staff Office
Stony Brook Univeristy Hospital
Stony Brook, NY 11794-7148
Phone (631) 444-2754

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150617002367 MD Order and Referring Only - DentistPractitioner - Dentist 1759692775

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14514MDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216166400000",
    "number": "1457515660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL HOUSE STAFF OFFICE",
            "address_2": "STONY BROOK UNIVERISTY HOSPITAL",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117947148",
            "telephone_number": "631-444-2754",
            "fax_number": "631-444-6031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL HOUSE STAFF OFFICE",
            "address_2": "STONY BROOK UNIVERISTY HOSPITAL",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117947148",
            "telephone_number": "631-444-2754",
            "fax_number": "631-444-6031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELTZER",
        "first_name": "JARED",
        "middle_name": "IAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-16",
        "last_updated": "2008-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.