Individual provider Active NPI

Stephen Demarco, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Albany, NY
National Provider Identifier
1578644464
Registry record updated May 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
039251-1 Issued in NY
Practice address
7 Southwoods Blvd
Albany, NY 12211-2526
Phone
(518) 445-2505
Fax
(518) 445-2508
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 039251-1 NY Primary

Addresses

Primary practice location

7 Southwoods Blvd
Albany, NY 12211-2526

Mailing address

7 Southwoods Blvd
Albany, NY 12211-2526
Phone (518) 445-2505

Other identifiers 2

IdentifierTypeStateIssuer
02241849MedicaidNY
10005149OtherNYCDPHP

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110428000023 NY Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 9234314766 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Oral Surgery
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7 Southwoods Blvd
Albany, NY 12211-2514

7 Southwoods Blvd
Albany, NY 12211-2578

Hospital & facility affiliations

  • St Peter'S Hospital Hospital, Albany, NY, CCN 330057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
039251NYMDPharmacist
039251-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Capital District Oral & Maxillofacial Surgeons,LLC Oral and Maxillofacial Surgery CurrentSince Jul 1, 2002 Accepting new patients

Locations

7 Southwoods Blvd
Albany, NY 12211
Phone (518) 292-6060

11 Century Hill Dr
Latham, NY 12110
Phone (518) 713-4595

Interoperability endpoints

  • Direct secure messaging: sdemarco788963@direct.trinity-health.org

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209686400000",
    "number": "1578644464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 SOUTHWOODS BLVD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122112526",
            "telephone_number": "518-445-2505",
            "fax_number": "518-445-2508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 SOUTHWOODS BLVD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122112526",
            "telephone_number": "518-445-2505",
            "fax_number": "518-445-2508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMARCO",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2008-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "039251-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02241849",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10005149",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.