Individual provider Active NPI

Seth R Stoller, M.D.

  • Neurology Physician
  • Summit, NJ
National Provider Identifier
1467408583
Registry record updated Sep 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
25MA07912600 Issued in NJ
Practice address
11 Overlook Road
B110
Summit, NJ 07901-3570
Phone
(908) 522-2709
Fax
(908) 522-6123
NPI assigned
May 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 25MA07912600 NJ Primary

Addresses

Primary practice location

11 Overlook Road
B110
Summit, NJ 07901-3570

Mailing address

PO Box 416457
Boston, MA 02241-6457

Other identifiers 1

IdentifierTypeStateIssuer
0066516MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20050610000332 NJ Practitioner - Neurology 4587608583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Rutgers New Jersey Medical School, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-5596

333 Mount Hope Ave
Rockaway, NJ 07866-1645
Phone (973) 895-6601

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07912600NJMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group CurrentSince Apr 15, 2014 Accepting new patients
Ahs Hospital Corp Past Accepting new patients

Locations

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

465 South St
Ste 103
Morristown, NJ 07960
Phone (973) 971-7130

333 Mount Hope Ave
Ste 220
Rockaway, NJ 07866
Phone (973) 267-2838

99 Beauvoir Ave
Summit, NJ 07901
Phone (908) 522-2232

11 Overlook Rd
Ste B110
Summit, NJ 07901
Phone (908) 522-2709

11 Overlook Rd
Ste 180
Summit, NJ 07901
Phone (973) 845-2500

550 1st Ave
New York, NY 10016
Phone (212) 263-3293

Organizations & group practices 2

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475020800000",
    "number": "1467408583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416457",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 OVERLOOK ROAD",
            "address_2": "B110",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013570",
            "telephone_number": "908-522-2709",
            "fax_number": "908-522-6123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLLER",
        "first_name": "SETH",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2016-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "25MA07912600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0066516",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

Verify at the official NPI Registry.