Individual provider Active NPI

Stanley Alan Fox, MD

  • Gastroenterology Physician
  • Massapequa, NY
National Provider Identifier
1780673566
Registry record updated Sep 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
122154 Issued in NY
Practice address
585 Broadway
Broadway Internal Medicine Associates
Massapequa, NY 11758-5023
Phone
(516) 797-1234
Fax
(516) 797-1932
NPI assigned
Oct 14, 2005
Last updated
Sep 26, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 122154 NY Primary

Addresses

Primary practice location

585 Broadway
Broadway Internal Medicine Associates
Massapequa, NY 11758-5023

Mailing address

585 Broadway
Massapequa, NY 11758-5023
Phone (516) 797-1234

Other identifiers 1

IdentifierTypeStateIssuer
00409196MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20050930000747 NY Practitioner - Internal MedicinePractitioner - Gastroenterology 8224063938 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
82.1
Promoting interoperability
100
Improvement activities
40
Cost
72.34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
122154NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Associates, PC CurrentSince Jul 1, 2020 Accepting new patients
Internal Medicine Associates, PC Gastroenterology CurrentSince Jul 1, 2020 Accepting new patients

Locations

585 Broadway
Massapequa, NY 11758
Phone (516) 360-2020

5499 Route 347
Mount Sinai, NY 11766
Phone (631) 331-3910

21422 73rd Ave
Oakland Gdns, NY 11364
Phone (718) 347-3500

243 Boyle Rd
Selden, NY 11784
Phone (631) 320-1247

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190764800000",
    "number": "1780673566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 BROADWAY",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585023",
            "telephone_number": "516-797-1234",
            "fax_number": "516-797-1932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 BROADWAY",
            "address_2": "BROADWAY INTERNAL MEDICINE ASSOCIATES",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585023",
            "telephone_number": "516-797-1234",
            "fax_number": "516-797-1932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "STANLEY",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2007-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "122154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00409196",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa, NY

Sources for this page

Verify at the official NPI Registry.