Active NPI
Stephanie Stolberg, M.D.
- Psychiatry Physician
- New York, NY
National Provider Identifier
1710116447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 272216
- Practice address
- 63 Wall St
Apt. 504
New York, NY 10005 - Phone
- (787) 385-6536
- NPI assigned
- Jul 1, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychiatry Physician | 2084P0800X | 272216 | NY | Primary |
Addresses
Primary practice location
63 Wall St
Apt. 504
New York, NY 10005
Mailing address
63 Wall St
Apt. 504
New York, NY 10005-3001
Phone (787) 385-6536
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Joseph'S Pathology, PC | Current | Accepting new patients | |
| St Josephs Medical PC | Past | Accepting new patients | |
| Anesthesiology Associates of Boro Park, LLP | Past | Accepting new patients | |
| MMC OB-GYN Faculty Practice Plan | Past | Accepting new patients |
Locations
301 Prospect Ave
Ste 706
Syracuse, NY 13203
Phone (315) 703-5200
301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111
301 Prospect Ave
Ofc
Syracuse, NY 13203
Phone (315) 448-2876
Interoperability endpoints
- sstolbery1448029@nychhc.direct-ci.com
Organizations & group practices 5
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.
-
- General Acute Care Hospital
- Syracuse, NY
- NPI 1508815333
-
- Anatomic Pathology & Clinical Pathology Physician
- Syracuse, NY
- NPI 1235121575
-
- Pain Medicine (Anesthesiology) Physician
- Brooklyn, NY
- NPI 1518912302
-
- Specialist
- Brooklyn, NY
- NPI 1306843388
-
- Family Medicine Physician
- Liverpool, NY
- NPI 1942501747
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528761600000",
"number": "1710116447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "63 WALL ST",
"address_2": "APT. 504",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100053001",
"telephone_number": "787-385-6536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "63 WALL ST",
"address_2": "APT. 504",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10005",
"telephone_number": "787-385-6536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOLBERG",
"first_name": "STEPHANIE",
"name_prefix": "Miss",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-01",
"last_updated": "2018-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "272216",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.