NPIMap

Organization Active NPI

Jay B Stambler MD Medical PC

  • Internal Medicine Physician
  • Patchogue, NY
National Provider Identifier
1841776952
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
135486 Issued in NY
Legal business name
JAY B STAMBLER MD MEDICAL PC
Practice address
450 Waverly Avenue BLD 3 Ste 1
Patchogue, NY 11772-1555
Phone
(631) 438-0333
Fax
(631) 438-0337
NPI assigned
Jul 12, 2018
Last updated
Jul 25, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Authorized official

Name
Dr. Jay B Stambler, MDNPI 1821029026
Title
President
Phone
(631) 438-0333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X 135486 NY Primary
Gastroenterology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RG0100X 135486 NY

Addresses

Primary practice location

450 Waverly Avenue BLD 3 Ste 1
Patchogue, NY 11772-1555

Mailing address

450 Waverly Avenue BLD 3 Ste 1
Patchogue, NY 11772-1555
Phone (631) 438-0333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181009003085 NY Part B Supplier - Clinic/Group Practice 7113279795 Receives reassigned benefits from 4 practitioners
Practice locations: Patchogue, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564012800000",
    "number": "1841776952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 WAVERLY AVENUE BLD 3 STE 1",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721555",
            "telephone_number": "631-438-0333",
            "fax_number": "631-438-0337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 WAVERLY AVENUE BLD 3 STE 1",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721555",
            "telephone_number": "631-438-0333",
            "fax_number": "631-438-0337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAY B STAMBLER MD MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-12",
        "last_updated": "2019-07-25",
        "status": "A",
        "authorized_official_last_name": "STAMBLER",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-438-0333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "135486",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "135486",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.