Mark Edward Stutzmann Jr., PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

031347 Issued in NY

Practice address

100 E 77TH St
New York, NY 10075-1850

Phone

(516) 384-9965

NPI assigned

Sep 25, 2023

Reactivated

Jan 17, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mstutzmann710878@nyumc.direct-ci.com

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.

• New York University

  dba NYU Faculty Group Practice

  • Cardiovascular Disease Physician
  • Boynton Beach, FL
  • NPI 1285826438

  NY

  Medicare reassignment Care Compare group NPD
• North Shore-Lij Medical PC

  dba NHPP Cardiology at Great Neck

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment
• New York University

  dba NYU Langone Ambulatory Care Chelsea

  • Physical Medicine & Rehabilitation Physician
  • Boynton Beach, FL
  • NPI 1104787613
  NPD

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1487433991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 W OAK HILL DR",
            "city": "OYSTER BAY",
            "state": "NY",
            "postal_code": "117713908",
            "telephone_number": "516-384-9965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E 77TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751850",
            "telephone_number": "516-384-9965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUTZMANN",
        "first_name": "MARK",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-25",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "deactivation_date": "2023-09-25",
        "reactivation_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "031347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney Sturner, LMSW
• Timothy Sturrock
• Courtney R Stursberg, LMSW
• Whitney Sturton, MS, RD
• Gabrielle Stutman, PHD
• Robert Nicolais Stuver, MDD
• Stuytown RX LLC (stuytown pharmacy)
• Stuyvesant Medical Group
• Ronald Jason Styka, PSY.D.
• Style-Eyes by Jennifer Inc.

• Surgical Physician Assistant in New York, NY
• Providers in New York, NY by specialty
• Surgical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.