Individual provider Active NPI

Jadwiga Katarzyna Stec

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1497283121
Registry record updated Sep 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
59872-1 Issued in NY
Practice address
179 Jamaica Ave
Brooklyn, NY 11207-2049
Phone
(929) 267-5354
Fax
(929) 267-5340
NPI assigned
May 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 59872-1 NY Primary

Addresses

Primary practice location

179 Jamaica Ave
Brooklyn, NY 11207-2049

Mailing address

936 Metropolitan Ave Apt 2B
Brooklyn, NY 11211-2657
Phone (718) 809-8156

Other practice location 1

451 Clarkson Ave
Brooklyn, NY 11203-2054
Phone (718) 245-2027

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220121000953 NY Practitioner - Oral SurgeryPractitioner - Dentist 6608268743 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
59872-1NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Medical Practice Plan PC CurrentSince Jul 1, 2022 Accepting new patients

Locations

1901 1st Ave
Rm 5M44
New York, NY 10029
Phone (212) 423-6262

1901 1st Ave
New York, NY 10029
Phone (212) 230-6262

Interoperability endpoints

  • Direct secure messaging: jstec1852170@nychhc.direct-ci.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.

NPI Registry JSON

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

{
    "created_epoch": "1495670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536710400000",
    "number": "1497283121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "936 METROPOLITAN AVE APT 2B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112112657",
            "telephone_number": "718-809-8156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 JAMAICA AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112072049",
            "telephone_number": "929-267-5354",
            "fax_number": "929-267-5340"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "451 Clarkson Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112032054",
            "country_code": "US",
            "telephone_number": "718-245-2027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEC",
        "first_name": "JADWIGA",
        "middle_name": "KATARZYNA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-25",
        "last_updated": "2018-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "59872-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.