Individual provider Active NPI

Mir Omer Talpur, MBBS

  • Psychiatry Physician
  • Stony Brook, NY
National Provider Identifier
1942862800
Registry record updated Jun 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
321245 Issued in NY
Practice address
101 Nicolls Rd
Stony Brook, NY 11794-2916
Phone
(973) 974-0267
Fax
(518) 351-6200
NPI assigned
Jul 1, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 321245 NY Primary

Addresses

Primary practice location

101 Nicolls Rd
Stony Brook, NY 11794-2916

Mailing address

4802 10TH Ave
Brooklyn, NY 11219-2916

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230629000498 NY Practitioner - Psychiatry 8921467689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

169 Putnam Hall
South Campus
Stony Brook, NY 11794-8790
Phone (631) 632-8850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
321245NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Psychiatric Associates, University Faculty Practice Corpor Psychiatry CurrentSince Jul 1, 2023 Accepting new patients
University Hospital at Stony Brook Past Accepting new patients

Locations

169 Putnam Hall
Stony Brook, NY 11794
Phone (631) 632-8850

Networks

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

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687651200000",
    "number": "1942862800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4802 10TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NICOLLS RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117942916",
            "telephone_number": "973-974-0267",
            "fax_number": "518-351-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALPUR",
        "first_name": "MIR OMER",
        "name_prefix": "Dr.",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-01",
        "last_updated": "2023-06-25",
        "certification_date": "2023-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "321245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.