Jack Stern, MD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

124524 Issued in NY

Practice address

915 Broadway
Ste 1200
New York, NY 10010-7108

Phone

(212) 228-4002

Fax

(914) 206-4590

NPI assigned

Mar 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2013 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Brain & Spine Surgeons of New York PC

  • Surgery Physician
  • White Plains, NY
  • NPI 1992921407
  NPD (past)
• Diagnostic Medicine Services NJ PC

  • Neurology Physician
  • New York, NY
  • NPI 1043742273
  NPD (past)
• Diagnostic Medicine Services PC

  • Electrodiagnostic Medicine Physician
  • New York, NY
  • NPI 1194191957
  NPD (past)
• Neuro and Orthopedic Monitoring and Testing Associates PLLC

  • Other Specialist/Technologist
  • New York, NY
  • NPI 1134593411
  NPD (past)
• Professional Monitoring and Testing Associates (Ma) LLC

  • Other Specialist/Technologist
  • New York, NY
  • NPI 1831563113
  NPD (past)
• Professional Monitoring and Testing Associates PC

  • Other Specialist/Technologist
  • New York, NY
  • NPI 1386018745
  NPD (past)
• Safe Passage Neuromonitoring, LLC

  • Neurology Physician
  • New York, NY
  • NPI 1922245935
  NPD (past)

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1730140666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 515",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148510515",
            "telephone_number": "855-522-7233",
            "fax_number": "914-206-4590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 BROADWAY",
            "address_2": "STE 1200",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100107108",
            "telephone_number": "212-228-4002",
            "fax_number": "914-206-4590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "JACK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NY",
            "license": "124524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Esme Stern
• Frederick Preston Stern, PH.D.
• Gloria Jean Stern, MD
• Hillary Gemma Stern, PSY.D.
• Izetta Siegal Stern, LCSW,BCD
• Jeffrey M Stern, MD
• Jenny Sandra Stern, L.C.S.W
• Jessica Stern, PH.D.
• Jordan C. Stern, M.D.
• Jordan Russell Stern, M.D.

• Neurological Surgery Physician in New York, NY
• Providers in New York, NY by specialty
• Neurological Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.