Individual provider Active NPI

Stephanie Bates, DO

  • Internal Medicine Physician
  • Ithaca, NY
National Provider Identifier
1467033985
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
322571-01 Issued in NY
Practice address
101 Dates Dr
Ithaca, NY 14850-1383
Phone
(607) 339-0630
NPI assigned
Apr 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 322571-01 NY Primary

Addresses

Primary practice location

101 Dates Dr
Ithaca, NY 14850-1383

Mailing address

101 Dates Dr
Ithaca, NY 14850-1383

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
I20240808002829 NY Practitioner - Internal Medicine 3173060092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cayuga Medical Associates PCGroup PAC ID 6709897960, 278 clinicians

Practice addresses (Care Compare)

310 Taughannock Blvd
Suite 4
Ithaca, NY 14850-3251
Phone (607) 269-0100

40 Catherwood Rd
Ithaca, NY 14850-1056
Phone (607) 272-0460

401 Cayuga Park LN
Ithaca, NY 14850-1180
Phone (607) 339-0625

Hospital & facility affiliations

  • Cayuga Medical Center at Ithaca Hospital, Ithaca, NY, CCN 330307

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
322571-01NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cayuga Medical Associates, PC Internal Medicine CurrentSince Sep 2, 2024 Accepting new patients

Locations

101 Harris B Dates Dr
Ithaca, NY 14850
Phone (607) 274-4011

310 Taughannock Blvd
Fl 4
Ithaca, NY 14850
Phone (607) 269-0100

Interoperability endpoints

  • Direct secure messaging: stephanie.bates.1@17251.direct.athenahealth.com
  • Direct secure messaging: sbates27397@direct.xtensys.com

Organizations & group practices 1

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 1

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": "1618531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1467033985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DATES DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DATES DR",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501383",
            "telephone_number": "607-339-0630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATES",
        "first_name": "STEPHANIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-16",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "322571-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.