Individual provider Active NPI

Alexandra Stang

  • Family Nurse Practitioner
  • East Setauket, NY
National Provider Identifier
1659054831
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
352426 Issued in NY
Practice address
100 S Jersey Ave Unit 16
East Setauket, NY 11733-2036
Phone
(631) 689-6400
NPI assigned
Aug 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X F352426-01 NY
Family Nurse Practitioner 363LF0000X 352426 NY Primary

Addresses

Primary practice location

100 S Jersey Ave Unit 16
East Setauket, NY 11733-2036

Mailing address

900 Merchants Concourse Ste 216
Westbury, NY 11590-5114
Phone (516) 226-8373

Other practice location 1

285 Sills Rd Ste D
East Patchogue, NY 11772-4869
Phone (631) 447-1032

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
352426NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Square Care Medical Group, LLP CurrentSince Sep 1, 2023 Accepting new patients

Locations

285 Sills Rd
Ste D
East Patchogue, NY 11772
Phone (631) 438-0777

285 Sills Rd
Bldg 7D
East Patchogue, NY 11772
Phone (631) 447-1032

191 Herricks Rd
New Hyde Park, NY 11040
Phone (516) 248-0144

100 S Jersey Ave
Unit 16
Setauket, NY 11733
Phone (631) 689-6400

900 Merchants Concourse
Ste 216
Westbury, NY 11590
Phone (516) 565-6322

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15987/brand/1/csg/1/fhir/r4

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": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1659054831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 MERCHANTS CONCOURSE STE 216",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115905114",
            "telephone_number": "516-226-8373",
            "fax_number": "516-226-8373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S JERSEY AVE UNIT 16",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117332036",
            "telephone_number": "631-689-6400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "285 Sills Rd Ste D",
            "address_purpose": "LOCATION",
            "city": "East Patchogue",
            "state": "NY",
            "postal_code": "117724869",
            "country_code": "US",
            "telephone_number": "631-447-1032",
            "fax_number": "631-447-7033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANG",
        "first_name": "ALEXANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "NY",
            "license": "F352426-01",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "352426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.