Individual provider Active NPI

Stanley Melchor Capulong Fuentes, MD

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1780333120
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
335218 Issued in NY
Practice address
1 Park Ave FL 7
New York, NY 10016-5818
Phone
(646) 754-5063
Fax
(646) 754-9538
NPI assigned
Mar 22, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 335218 NY Primary

Addresses

Primary practice location

1 Park Ave FL 7
New York, NY 10016-5818

Mailing address

1 Park Ave FL 7
New York, NY 10016-5818
Phone (646) 754-5063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20220627000328 LA Order and Referring Only - PsychiatryPractitioner - Psychiatry 4880073519

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
335218NYMDLicensed Practical Nurse

Interoperability endpoints

  • Direct secure messaging: sfuentes715719@nyumc.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1780333120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PARK AVE FL 7",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165818",
            "telephone_number": "646-754-5063",
            "fax_number": "646-754-9538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PARK AVE FL 7",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165818",
            "telephone_number": "646-754-5063",
            "fax_number": "646-754-9538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENTES",
        "first_name": "STANLEY MELCHOR",
        "middle_name": "CAPULONG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-22",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "335218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.