Active NPI
Stanley Brooke Kantor, DO
- Family Medicine Physician
- Seattle, WA
National Provider Identifier
1790857241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 252070000OP704
- Practice address
- 9208 Roosevelt Way NE
Seattle, WA 98115-2842 - Phone
- (206) 523-7700
- Fax
- (206) 523-7702
- NPI assigned
- Nov 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 252070000OP704 | WA | Primary |
| Family Medicine Physician | 207Q00000X | 16370 | GA | |
| Family Medicine Physician | 207Q00000X | 5101007108 | MI |
Addresses
Primary practice location
9208 Roosevelt Way NE
Seattle, WA 98115-2842
Mailing address
9208 Roosevelt Way NE
Seattle, WA 98115
Phone (206) 523-7700
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1443407 | Medicaid | WA | |
| 14428 | Other | WA | L I COMP |
Other names 1
- Dr. Stanley B Kantor
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101007108 | MI | MD | Family Medicine Physician |
| 252070000OP704 | WA | MD | Family Medicine Physician |
| 16370 | GA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196985600000",
"number": "1790857241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9208 ROOSEVELT WAY NE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98115",
"telephone_number": "206-523-7700",
"fax_number": "206-523-7702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9208 ROOSEVELT WAY NE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981152842",
"telephone_number": "206-523-7700",
"fax_number": "206-523-7702"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANTOR",
"first_name": "STANLEY",
"middle_name": "BROOKE",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-13",
"last_updated": "2007-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "252070000OP704",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GA",
"license": "16370",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "5101007108",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1443407",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L I COMP",
"identifier": "14428",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "STANLEY",
"last_name": "KANTOR",
"middle_name": "B",
"prefix": "DR.",
"credential": "DO",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.