Individual provider Active NPI

Ronald Stevens, M.D.

  • Cardiovascular Disease Physician
  • Mineola, NY
National Provider Identifier
1639230758
Registry record updated Jun 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
209886 Issued in NY
Practice address
166 E Jericho Tpke
Mineola, NY 11501-2098
Phone
(516) 408-3423
Fax
(516) 294-2734
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2012

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 209886 NY Primary

Addresses

Primary practice location

166 E Jericho Tpke
Mineola, NY 11501-2098

Mailing address

166 E Jericho Tpke
Mineola, NY 11501-2098
Phone (516) 408-3423

Other identifiers 14

IdentifierTypeStateIssuer
201285536OtherUHC
01920332MedicaidNY
118397OtherVYTRA
5460420OtherCIGNA
7249304OtherAETNA
201285536OtherEMPIRE
201285536OtherHORIZON
AA72388AOtherMDNY
P00235529OtherRR MCR
193073POtherHIP
2590248OtherGHI
292AU1OtherBLUE CROSS BLUE SHIELD
4C9691OtherHEALTHNET
P1219927OtherOXFORD

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
I20041206000348 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8022074681 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
New York Medical College, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

22 Jericho Tpke
Suite 105
Mineola, NY 11501-2937
Phone (516) 408-3423

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Health Care of Mineola PC CurrentSince Oct 15, 2009 Accepting new patients
Ronald a Stevens MD, PC Cardiovascular Disease CurrentSince Oct 15, 2009 Accepting new patients
Franklin Hospital Past Accepting new patients

Locations

166 E Jericho Tpke
Mineola, NY 11501
Phone (516) 294-1100

22 Jericho Tpke
Ste 105
Mineola, NY 11501
Phone (516) 294-1100

166 E Jericho Tpke
Ste 10
Mineola, NY 11501
Phone (516) 294-1100

21422 73rd Ave
Oakland Gdns, NY 11364
Phone (718) 347-3500

Organizations & group practices 3

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1639230758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 E JERICHO TPKE",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115012098",
            "telephone_number": "516-408-3423",
            "fax_number": "516-294-2734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 E JERICHO TPKE",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115012098",
            "telephone_number": "516-408-3423",
            "fax_number": "516-294-2734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "RONALD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "209886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "201285536",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01920332",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VYTRA",
            "identifier": "118397",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5460420",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7249304",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE",
            "identifier": "201285536",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON",
            "identifier": "201285536",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDNY",
            "identifier": "AA72388A",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P00235529",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "193073P",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "2590248",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "292AU1",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "4C9691",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1219927",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.