Individual provider Active NPI

Jay A. Stiefel, D.O.

  • Emergency Medicine Physician
  • Woodbury, NJ
National Provider Identifier
1780600338
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MB50299 Issued in NJ
Practice address
509 N Broad St
Woodbury, NJ 08096-1617
Phone
(856) 853-2001
NPI assigned
Jul 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MB50299 NJ Primary

Addresses

Primary practice location

509 N Broad St
Woodbury, NJ 08096-1617

Mailing address

307 S Evergreen Ave
Woodbury, NJ 08096-2739

Other identifiers 6

IdentifierTypeStateIssuer
90000011100OtherNJAMERICHOICE
222137644OtherNJCHAMPUS/TRICARE
2255804MedicaidNJ
0404825000OtherNJAMERIHEALTH
1097480OtherNJKEY/MER
222137644OtherNJBCBSNJ

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
I20040810001177 NJ Practitioner - Emergency MedicinePractitioner - Internal Medicine 5698747608 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MB50299NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Care Services of New Jersey, PA Emergency Medicine CurrentSince Jun 1, 2008 Accepting new patients
Emergency Physician Associates of South Jersey P C Emergency Medicine Past Accepting new patients
Eps Billing, LLC Past Accepting new patients

Locations

307 S Evergreen Ave
Woodbury, NJ 08096
Phone (856) 686-4300

509 N Broad St
Woodbury, NJ 08096
Phone (856) 686-5396

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1780600338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 S EVERGREEN AVE",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080962739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 N BROAD ST",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080961617",
            "telephone_number": "856-853-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIEFEL",
        "first_name": "JAY",
        "middle_name": "A.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "MB50299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "90000011100",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS/TRICARE",
            "identifier": "222137644",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2255804",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0404825000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEY/MER",
            "identifier": "1097480",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNJ",
            "identifier": "222137644",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NJ

Sources for this page

Verify at the official NPI Registry.