Individual provider Active NPI

Elliott Mark Stein, MD

  • Cardiovascular Disease Physician
  • Springfield, NJ
National Provider Identifier
1508851965
Registry record updated May 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MA28384 Issued in NJ
Practice address
211 Mountain Ave
Associates in Cardiovascular Disease. LLC
Springfield, NJ 07081-2221
Phone
(973) 467-0005
Fax
(973) 912-8989
NPI assigned
Sep 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MA28384 NJ Primary

Addresses

Primary practice location

211 Mountain Ave
Associates in Cardiovascular Disease. LLC
Springfield, NJ 07081-2221

Mailing address

PO Box 416457
Practice Associates Medical Group
Boston, MA 02241-6457
Phone (973) 656-6280

Other identifiers 1

IdentifierTypeStateIssuer
2399300MedicaidNJ

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
I20051117000628 NJ Practitioner - Cardiovascular Disease (Cardiology) 2668468950 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA28384NJMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Union Hospital Family Health Center Cardiovascular Disease Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368057600000",
    "number": "1508851965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416457",
            "address_2": "PRACTICE ASSOCIATES MEDICAL GROUP",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416457",
            "telephone_number": "973-656-6280",
            "fax_number": "973-290-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 MOUNTAIN AVE",
            "address_2": "ASSOCIATES IN CARDIOVASCULAR DISEASE. LLC",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070812221",
            "telephone_number": "973-467-0005",
            "fax_number": "973-912-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEIN",
        "first_name": "ELLIOTT",
        "middle_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2013-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "MA28384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2399300",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, NJ

Sources for this page

Verify at the official NPI Registry.