NPIMap

Individual provider Active NPI

Stephanie N Gilleran, DO

  • Pulmonary Disease Physician
  • East Patchogue, NY
National Provider Identifier
1902892581
Registry record updated Aug 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
221807 Issued in NY
Practice address
285 Sills Rd
Building 7, Suite B
East Patchogue, NY 11772-4869
Phone
(631) 654-4577
Fax
(631) 654-3391
NPI assigned
Sep 20, 2005
Last updated
Aug 16, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 221807 NY Primary

Addresses

Primary practice location

285 Sills Rd
Building 7, Suite B
East Patchogue, NY 11772-4869

Mailing address

285 Sills Rd
Building 7, Suite B
East Patchogue, NY 11772-4869
Phone (631) 654-4577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041116001029 NY Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 4183688476 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
New York College of Osteo Medicine of New York Institute of Technology, 1998
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) 444-1750

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-0580

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
221807NYMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Internists, University Faculty Practice Corporation Pulmonary Disease CurrentSince Oct 19, 2022 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Oct 19, 2022 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Past Accepting new patients

Locations

26 Research Way
East Setauket, NY 11733
Phone (631) 444-0502

200 Motor Pkwy
Ste C16
Hauppauge, NY 11788
Phone (631) 638-4933

1500 Route 112
Ste B
Port Jefferson Station, NY 11776
Phone (631) 343-4184

47 Commerce Ave
Ste 1
Riverhead, NY 11901
Phone (631) 978-7633

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

Networks

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187222400000",
    "number": "1902892581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 SILLS RD",
            "address_2": "BUILDING 7, SUITE B",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724869",
            "telephone_number": "631-654-4577",
            "fax_number": "631-654-3391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 SILLS RD",
            "address_2": "BUILDING 7, SUITE B",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724869",
            "telephone_number": "631-654-4577",
            "fax_number": "631-654-3391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLERAN",
        "first_name": "STEPHANIE",
        "middle_name": "N",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-20",
        "last_updated": "2007-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "221807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Patchogue, NY

Sources for this page

Verify at the official NPI Registry.