Individual provider Active NPI

Jay I Stylman, MD

  • Surgery Physician
  • Kearny, NJ
National Provider Identifier
1760414700
Registry record updated May 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MA52191 Issued in NJ
Practice address
847 Kearny Ave
Kearny, NJ 07032-3209
Phone
(201) 991-0041
Fax
(201) 991-5305
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2014

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 MA52191 NJ Primary

Addresses

Primary practice location

847 Kearny Ave
Kearny, NJ 07032-3209

Mailing address

847 Kearny Ave
Kearny, NJ 07032-3209
Phone (201) 991-0041

Other identifiers 1

IdentifierTypeStateIssuer
0272205MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20071127000289 NJ Practitioner - General Surgery 1658469739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
New York Medical College, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Avenue Professional Services, PCGroup PAC ID 7214258003, 49 clinicians

Practice addresses (Care Compare)

111 Central Ave
Newark, NJ 07102-1909
Phone (973) 877-5300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA52191NJMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Avenue Professional Services, PC Surgery CurrentSince Jan 1, 2016 Accepting new patients

Locations

111 Central Ave
Newark, NJ 07102
Phone (973) 877-5060

268 Mlk Jr Blvd
Newark, NJ 07102
Phone (973) 877-2580

350 Boulevard
Passaic, NJ 07055
Phone (973) 365-4300

81 Northfield Ave
Ste 101
West Orange, NJ 07052
Phone (973) 699-5931

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 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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399248000000",
    "number": "1760414700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "847 KEARNY AVE",
            "city": "KEARNY",
            "state": "NJ",
            "postal_code": "070323209",
            "telephone_number": "201-991-0041",
            "fax_number": "201-991-5305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "847 KEARNY AVE",
            "city": "KEARNY",
            "state": "NJ",
            "postal_code": "070323209",
            "telephone_number": "201-991-0041",
            "fax_number": "201-991-5305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STYLMAN",
        "first_name": "JAY",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2014-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "MA52191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0272205",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearny, NJ

Sources for this page

Verify at the official NPI Registry.