NPIMap

Organization Active NPI

Stony Brook Internists, University Faculty Practice Corporation

  • Rheumatology Physician
  • Stony Brook, NY
National Provider Identifier
1659310241
Registry record updated Oct 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
Legal business name
STONY BROOK INTERNISTS, UNIVERSITY FACULTY PRACTICE CORPORATION
Practice address
Suny @ Stony Brook
HSC, L16, RM 020
Stony Brook, NY 11794-0001
Phone
(631) 444-2448
NPI assigned
Jun 6, 2006
Last updated
Oct 28, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
STONY BROOK INTERNISTS, UNIVERSITY FACULTY PRACTICE CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 28, 2014

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

Authorized official

Name
Vincent Yang, MD, PHD
Title
President
Phone
(631) 444-2448

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X NU Primary

Addresses

Primary practice location

Suny @ Stony Brook
HSC, L16, RM 020
Stony Brook, NY 11794-0001

Mailing address

PO Box 1554
Stony Brook, NY 11790-0988
Phone (631) 444-2448

Other identifiers 2

IdentifierTypeStateIssuer
00615265MedicaidNY
CB8937OtherNYRAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040731000094 NY Part B Supplier - Clinic/Group Practice 9133019821 Receives reassigned benefits from 41 practitioners
1 other NPI on this enrollment
Practice locations: East Setauket, NY; New Hyde Park, NY; New York, NY; Stony Brook, NY; Stonybrook, NY

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Haldun C Mutlu

Locations

26 Research Way
East Setauket, NY 11733
Phone (631) 444-0502

Practitioners & affiliated clinicians

Practitioners 42

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414454400000",
    "number": "1659310241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1554",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900988",
            "telephone_number": "631-444-2448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SUNY @ STONY BROOK",
            "address_2": "HSC, L16, RM 020",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-444-2448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONY BROOK INTERNISTS, UNIVERSITY FACULTY PRACTICE CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STONY BROOK INTERNISTS, UNIVERSITY FACULTY PRACTICE CORPORATION",
        "enumeration_date": "2006-06-06",
        "last_updated": "2014-10-28",
        "status": "A",
        "authorized_official_last_name": "YANG",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-444-2448",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00615265",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "CB8937",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.