Active NPI
Robert Michael Stark, M.D.
- Cardiovascular Disease Physician
- Greenwich, CT
National Provider Identifier
1871503383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 020817
- Practice address
- 40 W Elm St
Greenwich, CT 06830-6425 - Phone
- (203) 622-1102
- Fax
- (203) 622-1508
- NPI assigned
- Aug 8, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 020817 | CT | Primary |
Addresses
Primary practice location
40 W Elm St
Greenwich, CT 06830-6425
Mailing address
40 W Elm St
Greenwich, CT 06830-6425
Phone (203) 622-1102
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 020817 | CT | MD | Cardiovascular Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282003200000",
"number": "1871503383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 W ELM ST",
"city": "GREENWICH",
"state": "CT",
"postal_code": "068306425",
"telephone_number": "203-622-1102",
"fax_number": "203-622-1508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 W ELM ST",
"city": "GREENWICH",
"state": "CT",
"postal_code": "068306425",
"telephone_number": "203-622-1102",
"fax_number": "203-622-1508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STARK",
"first_name": "ROBERT",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-08",
"last_updated": "2010-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "CT",
"license": "020817",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Greenwich, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.