NPIMap

Individual provider Active NPI

Peter David Stetson, M.D.

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1639277387
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
209729 Issued in NY
Practice address
622 W 168TH St
New York, NY 10032-3720
Phone
(212) 305-5138
NPI assigned
Sep 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 209729 NY Primary

Addresses

Primary practice location

622 W 168TH St
New York, NY 10032-3720

Mailing address

630 W 168TH St # 4
VC 12TH Floor, Suite 208
New York, NY 10032-3725

Other identifiers 1

IdentifierTypeStateIssuer
01953704MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110103000425 NY Practitioner - Internal Medicine 8527256742 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75.5 of 100Reported as group
Quality
60.62
Improvement activities
40
Cost
73.87

Merit-based Incentive Payment System (MIPS)

Final score
77.91 of 100Reported as group
Quality
78.66
Improvement activities
40
Cost
48.83

Merit-based Incentive Payment System (MIPS)

Final score
86.55 of 100Reported as group
Quality
82.52
Improvement activities
40
Cost
72.02

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209729NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Medical Consultation Group Internal Medicine CurrentSince Sep 21, 2015 Accepting new patients
Memorial Solid Tumor Group Internal Medicine CurrentSince Mar 1, 2020 Accepting new patients
Memorial Developmental Chemo Group CurrentSince Jan 31, 2024 Accepting new patients
Trustees of Columbia University in the City of New York Internal Medicine Past Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients
Trustees of Columbia University in City of Ny Hematology Oncology Past Accepting new patients
The New York and Presbyterian Hospital Internal Medicine Past Accepting new patients
Trustees of Columbia University in the City of New York Internal Medicine Past Accepting new patients

Locations

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

633 3rd Ave
Fl 4
New York, NY 10017
Phone (646) 227-3764

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: pstetson37184@mskcc.direct-ci.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639277387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 W 168TH ST # 4",
            "address_2": "VC 12TH FLOOR, SUITE 208",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "212-305-5138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STETSON",
        "first_name": "PETER",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "209729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01953704",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.