Individual provider Active NPI

Jack Fuhrer, M.D.

  • Infectious Disease Physician
  • East Setauket, NY
National Provider Identifier
1790710929
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
175545 Issued in NY
Practice address
205 N Belle Mead Rd
East Setauket, NY 11733
Phone
(631) 444-4660
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 175545 NY Primary

Addresses

Primary practice location

205 N Belle Mead Rd
East Setauket, NY 11733

Mailing address

P.O. Box 1559
Stony Brook, NY 11790
Phone (631) 444-1660

Other identifiers 2

IdentifierTypeStateIssuer
5063098OtherNYAETNA
01087374MedicaidNY

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
I20100216000312 NY Practitioner - Infectious Disease 7315081205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Rush Medical College of Rush University, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-1560

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-1560

205 N Belle Mead Rd
East Setauket, NY 11733-3483
Phone (631) 444-4630

26 Research Way
East Setauket, NY 11733-3526
Phone (631) 444-0580

Lauterbur Dr
Stony Brook, NY 11794-0001
Phone (632) 638-1000

PO Box
Suite 1554
Stony Brook, NY 11790-0989

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
175545NYMDInfectious Disease Physician

Practice roles (3 of 7)

OrganizationSpecialtyStatusNew patients
Stony Brook Internists, University Faculty Practice Corporation Infectious Disease CurrentSince Mar 31, 1988 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Current Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Mar 31, 1988 Accepting new patients

Locations

205 N Belle Mead Rd
Setauket, NY 11733
Phone (631) 444-1660

100 Nicolls Rd
#13202
Stony Brook, NY 11794

Networks

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

Interoperability endpoints

  • Direct secure messaging: jack.fuhrer@direct.stonybrookmedicine.edu

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.

Hospital & facility affiliations 6

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1790710929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1559",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11790",
            "telephone_number": "631-444-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N BELLE MEAD RD",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "11733",
            "telephone_number": "631-444-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUHRER",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NY",
            "license": "175545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5063098",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01087374",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

Verify at the official NPI Registry.