Individual provider Active NPI

Paul Stelzer, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • New York, NY
National Provider Identifier
1467436162
Registry record updated Sep 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
1167391 Issued in NY
Practice address
1190 5TH Ave # 1028
New York, NY 10029-6503
Phone
(212) 659-6871
Fax
(212) 659-6818
NPI assigned
Dec 6, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 1167391 NY Primary

Addresses

Primary practice location

1190 5TH Ave # 1028
New York, NY 10029-6503

Mailing address

1190 5TH Ave # 1028
New York, NY 10029-6574
Phone (212) 659-6871

Other identifiers 1

IdentifierTypeStateIssuer
00634533MedicaidNY

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
I20070403000520 NY Practitioner - Cardiovascular Disease (Cardiology) 1557465390 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1167391NYMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince May 1, 2013 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince May 1, 2013 Accepting new patients
Mount Sinai School of Medicine Past Accepting new patients

Locations

14004 58th Rd
Flushing, NY 11355
Phone (718) 463-4155

5 E 98th St
Fl 3
New York, NY 10029
Phone (212) 241-5170

1190 5th Ave
#2W
New York, NY 10029
Phone (212) 241-5646

150 E 42nd St
New York, NY 10017
Phone (212) 661-8139

1190 5th Ave
New York, NY 10029
Phone (212) 241-6756

1190 5th Ave
#1028
New York, NY 10029
Phone (212) 659-6864

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

Networks

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190764800000",
    "number": "1467436162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 5TH AVE # 1028",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296574",
            "telephone_number": "212-659-6871",
            "fax_number": "212-659-6818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 5TH AVE # 1028",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296503",
            "telephone_number": "212-659-6871",
            "fax_number": "212-659-6818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STELZER",
        "first_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2007-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NY",
            "license": "1167391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00634533",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.