Stony Brook Primary Care LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

STONY BROOK PRIMARY CARE LLC

Practice address

20 Research PL
Suite 100
North Chelmsford, MA 01863-2454

Phone

(978) 446-9850

Fax

(855) 283-4714

NPI assigned

Jun 10, 2008

Organization subpart

No

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

Authorized official

Name

Jessica Wieselquist, MDNPI 1144255712

Title

Owner/Provider

Phone

(978) 303-7179

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1850/brand/1/csg/1/fhir/r4

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jessica Wieselquist, MD

  • Internal Medicine Physician
  • North Chelmsford, MA
  • NPI 1144255712
  Medicare reassignment Care Compare group NPD Authorized official
• Dorothy F Semonian, NP

  • Family Nurse Practitioner
  • Chelmsford, MA
  • NPI 1568497105
  Medicare reassignment Care Compare group NPD
• David B Earle, MD

  • Surgery Physician
  • Springfield, MA
  • NPI 1780779934
  NPD (past)

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501459200000",
    "number": "1790945160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 RESEARCH PL",
            "address_2": "SUITE 100",
            "city": "NORTH CHELMSFORD",
            "state": "MA",
            "postal_code": "018632454",
            "telephone_number": "978-446-9850",
            "fax_number": "855-283-4714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 RESEARCH PL",
            "address_2": "SUITE 100",
            "city": "NORTH CHELMSFORD",
            "state": "MA",
            "postal_code": "018632454",
            "telephone_number": "978-446-9850",
            "fax_number": "855-283-4714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONY BROOK PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-10",
        "last_updated": "2017-07-31",
        "status": "A",
        "authorized_official_last_name": "WIESELQUIST",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "978-303-7179",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott A Sigman, MD
• Chandra Simonds, LICSW
• Kwende Smith, DPM
• Staffing Embassy Inc
• Stephanie M. Oliva MD PC
• June M Stott, ARNP
• Laurence E Sweeney, R.PH.
• Joanne Tarantino, MSW, LICSW
• Kurt Tautenhan
• Brittany Tavano, OTR/L

• Internal Medicine Physician in North Chelmsford, MA
• Providers in North Chelmsford, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.