Samuel J. Stein M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

084436 Issued in NY

Legal business name

SAMUEL J. STEIN M.D.

Practice address

51 Hurley Ave
Suite 3
Kingston, NY 12401-3747

Phone

(845) 338-0165

Fax

(845) 338-0619

NPI assigned

May 19, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Samuel J Stein, M.D.

Title

Physician

Phone

(845) 338-0165

Specialties & licenses 1

Addresses

Other identifiers 9

Locations

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

{
    "created_epoch": "1431993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431993600000",
    "number": "1699154039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 HURLEY AVE",
            "address_2": "SUITE 3",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013747",
            "telephone_number": "845-338-0165",
            "fax_number": "845-338-0619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 HURLEY AVE",
            "address_2": "SUITE 3",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124013747",
            "telephone_number": "845-338-0165",
            "fax_number": "845-338-0619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL J. STEIN M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-19",
        "last_updated": "2015-05-19",
        "status": "A",
        "authorized_official_last_name": "STEIN",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "845-338-0165",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "084436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA IDENTIFICATION NUMBER",
            "identifier": "I4198515",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P00814179",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE IDENTIFICATION NUMBER",
            "identifier": "0481714",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI IDENTIFICATION NUMBER",
            "identifier": "0041812",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP IDENTIFICATION NUMBER",
            "identifier": "10023501",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00525879",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI HMO IDENTIFICATION NUMBER",
            "identifier": "103235",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE IDENTIFICATION NUMBER",
            "identifier": "103235",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD IDENTIFICATION NUMBER",
            "identifier": "153461",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Kingston, NY
• Providers in Kingston, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2015; 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.