Individual provider Active NPI

Stuart Howard Ditchek, M.D.

  • General Practice Physician
  • Brooklyn, NY
National Provider Identifier
1528068103
Registry record updated May 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
174976 Issued in NY
Practice address
1762 E 23Rd St
Brooklyn, NY 11229
Phone
(718) 382-0012
Fax
(718) 382-0158
NPI assigned
Jul 26, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 174976 NY Primary

Addresses

Primary practice location

1762 E 23Rd St
Brooklyn, NY 11229

Mailing address

1762 E 23Rd St
Brooklyn, NY 11229-1521
Phone (718) 382-0012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210607003034 NY Practitioner - Pediatric Medicine 2062790744
I20211222000848 NJ Practitioner - General Practice 2062790744

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
174976NYMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: stuartditchek@mai.allscriptsdirect.net

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": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526428800000",
    "number": "1528068103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1762 E 23RD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291521",
            "telephone_number": "718-382-0012",
            "fax_number": "718-382-0158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1762 E 23RD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11229",
            "telephone_number": "718-382-0012",
            "fax_number": "718-382-0158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITCHEK",
        "first_name": "STUART",
        "middle_name": "HOWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2018-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "174976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.