Individual provider Active NPI

Richard Tuckman

  • Internal Medicine Physician
  • Stony Brook, NY
National Provider Identifier
1487657649
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
195463 Issued in NY
Practice address
Student Health Service, Stony Brook University
1 Stadium Road
Stony Brook, NY 11794-3191
Phone
(631) 632-6171
Fax
(631) 632-6936
NPI assigned
May 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 195463 NY Primary

Addresses

Primary practice location

Student Health Service, Stony Brook University
1 Stadium Road
Stony Brook, NY 11794-3191

Mailing address

20 Andrea Dr
Setauket, NY 11733-1905
Phone (631) 941-4044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
195463NYMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1487657649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 ANDREA DR",
            "city": "SETAUKET",
            "state": "NY",
            "postal_code": "117331905",
            "telephone_number": "631-941-4044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STUDENT HEALTH SERVICE, STONY BROOK UNIVERSITY",
            "address_2": "1 STADIUM ROAD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117943191",
            "telephone_number": "631-632-6171",
            "fax_number": "631-632-6936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKMAN",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "195463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.