Individual provider Active NPI

James Stillerman, MD

  • Surgery Physician
  • Watertown, NY
National Provider Identifier
1699881573
Registry record updated Nov 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
226115 Issued in NY
Practice address
165 Coleman Ave
Watertown, NY 13601-2217
Phone
(315) 755-2024
NPI assigned
Aug 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 226115 NY Primary

Addresses

Primary practice location

165 Coleman Ave
Watertown, NY 13601-2217

Mailing address

165 Coleman Ave
Watertown, NY 13601-2217
Phone (315) 755-2024

Other identifiers 1

IdentifierTypeStateIssuer
02370836MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041008000137 NY Practitioner - General Surgery 3072572627 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
New York Medical College, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Samaritan Medical CenterGroup PAC ID 8123914876, 157 clinicians

Practice addresses (Care Compare)

165 Coleman Ave
Watertown, NY 13601-2217
Phone (315) 755-2024

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue713
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Medical Center CurrentSince Jan 10, 2023 Accepting new patients
Clifton-Fine Healthcare Corporation CurrentSince Jun 1, 2019 Accepting new patients

Locations

1014 Oswegatchie Trail Rd
Star Lake, NY 13690
Phone (315) 848-3351

1575 Washington St
Watertown, NY 13601
Phone (315) 779-5060

165 Coleman Ave
Watertown, NY 13601
Phone (315) 755-2024

830 Washington St
Watertown, NY 13601
Phone (315) 785-4000

830 Washington St
#13282
Watertown, NY 13601
Phone (315) 785-4667

Interoperability endpoints

  • Direct secure messaging: james.stillerman@sfhcny.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448323200000",
    "number": "1699881573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 COLEMAN AVE",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012217",
            "telephone_number": "315-755-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 COLEMAN AVE",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012217",
            "telephone_number": "315-755-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILLERMAN",
        "first_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2015-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "226115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02370836",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

Verify at the official NPI Registry.