Individual provider Active NPI

Edward Lorenzo Sta. Maria, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • New York, NY
National Provider Identifier
1780768986
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
209232-1 Issued in NY
Practice address
506 Malcolm X Blvd
New York, NY 10037-1802
Phone
(212) 939-3628
Fax
(212) 939-3629
NPI assigned
Oct 24, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X 209232-1 NY
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 209232-1 NY Primary

Addresses

Primary practice location

506 Malcolm X Blvd
New York, NY 10037-1802

Mailing address

4056 Gleane St
Elmhurst, NY 11373-1429

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
I20180518000320 NY Practitioner - Pathology 9234107798 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Medical College of Ohio, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TBHC Medical Testing Services PCGroup PAC ID 6305982513, 4 clinicians
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

121 Dekalb Ave
Brooklyn, NY 11201-5425
Phone (718) 250-8155

888 Old Country Rd
Plainview, NY 11803-4914
Phone (516) 719-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209232-1NYMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Apr 18, 2022 Accepting new patients
Harlem Medical Associates PC CurrentSince Mar 28, 2018 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Manhasset, NY 11030

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

888 Old Country Rd
Plainview, NY 11803
Phone (516) 719-2543

45 Research Way
Ste 206
Setauket, NY 11733
Phone (631) 575-9300

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

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.

Hospital & facility affiliations 2

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1780768986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4056 GLEANE ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 MALCOLM X BLVD",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100371802",
            "telephone_number": "212-939-3628",
            "fax_number": "212-939-3629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STA. MARIA",
        "first_name": "EDWARD",
        "middle_name": "LORENZO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "NY",
            "license": "209232-1",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "209232-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.