Individual provider Active NPI

Stephen M Dillon, MD

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1609855394
Registry record updated Dec 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
157341 Issued in NY
Practice address
314 West 14TH St
5TH Floor
New York, NY 10014
Phone
(212) 620-0144
Fax
(212) 691-8588
NPI assigned
Jan 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2012

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 157341 NY Primary

Addresses

Primary practice location

314 West 14TH St
5TH Floor
New York, NY 10014

Mailing address

314 W 14TH St
5TH Floor
New York, NY 10014-5002
Phone (212) 620-0144

Other identifiers 1

IdentifierTypeStateIssuer
01535919MedicaidNY

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
I20050104000917 NY Practitioner - Internal Medicine 1052369246

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
157341NYMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354579200000",
    "number": "1609855394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 W 14TH ST",
            "address_2": "5TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100145002",
            "telephone_number": "212-620-0144",
            "fax_number": "212-691-8588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 WEST 14TH ST",
            "address_2": "5TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10014",
            "telephone_number": "212-620-0144",
            "fax_number": "212-691-8588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLON",
        "first_name": "STEPHEN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2012-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "157341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01535919",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.