NPIMap

Individual provider Active NPI

Kevin J. Schiller, D.O.

  • Family Medicine Physician
  • East Setauket, NY
National Provider Identifier
1710901921
Registry record updated Jul 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
211383 Issued in NY
Practice address
4 Technology Dr
Suite 210
East Setauket, NY 11733-4068
Phone
(631) 331-1506
Fax
(631) 331-1705
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 211383 NY Primary

Addresses

Primary practice location

4 Technology Dr
Suite 210
East Setauket, NY 11733-4068

Mailing address

PO Box 1559
Stony Brook, NY 11790-0989
Phone (631) 331-1506

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040409000089 NY Practitioner - Family Practice 4486648805 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-5858

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-5858

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Family and Preventive Medicine, University Faculty Practic Family Medicine CurrentSince Sep 1, 2019 Accepting new patients

Locations

4 Technology Dr
Ste 210
East Setauket, NY 11733
Phone (631) 331-1506

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: kevin.schiller@sbcm.cernerdirect.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1710901921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900989",
            "telephone_number": "631-331-1506",
            "fax_number": "631-331-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 TECHNOLOGY DR",
            "address_2": "SUITE 210",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117334068",
            "telephone_number": "631-331-1506",
            "fax_number": "631-331-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHILLER",
        "first_name": "KEVIN",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "211383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.