Individual provider Active NPI

Joel Germain Stanchina, MD

  • Nephrology Physician
  • Brooklyn, NY
National Provider Identifier
1669454161
Registry record updated Oct 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
147373 Issued in NY
Practice address
2146 Beverley Rd
Brooklyn, NY 11226-5406
Phone
(718) 469-6600
Fax
(718) 856-0714
NPI assigned
Nov 18, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 147373 NY Primary

Addresses

Primary practice location

2146 Beverley Rd
Brooklyn, NY 11226-5406

Mailing address

7328 185TH St
Fresh Meadows, NY 11366-1717
Phone (718) 454-3436

Other identifiers 1

IdentifierTypeStateIssuer
00775035MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
147373NYMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mohammad Siddique Physician PC Past Accepting new patients
Mill Basin Medical Services PC Past Accepting new patients

Organizations & group practices 2

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": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287446400000",
    "number": "1669454161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7328 185TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661717",
            "telephone_number": "718-454-3436",
            "fax_number": "718-252-6490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2146 BEVERLEY RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112265406",
            "telephone_number": "718-469-6600",
            "fax_number": "718-856-0714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANCHINA",
        "first_name": "JOEL",
        "middle_name": "GERMAIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2010-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "147373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00775035",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.