Individual provider Active NPI

Daniel Coldren, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Stony Brook, NY
National Provider Identifier
1952720583
Registry record updated May 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
2018-00005 Issued in NC
Practice address
Stony Brook University Hospital
Medical/House Staff Services
Stony Brook, NY 11794-7097
Phone
(631) 444-8413
Fax
(631) 706-3002
NPI assigned
Apr 10, 2014
Last updated
May 14, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 2018-00005 NC Primary

Addresses

Primary practice location

Stony Brook University Hospital
Medical/House Staff Services
Stony Brook, NY 11794-7097

Mailing address

Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180622000846 NC Practitioner - Pathology 7315292992 Reassigns benefits to 1 organization
I20241224000837 MI Practitioner - Pathology 7315292992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Health Management GroupGroup PAC ID 8628985215, 18 clinicians

Practice addresses (Care Compare)

4000 S Saginaw St
Flint, MI 48507-2604
Phone (810) 396-5747

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2018-00005NCMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Jun 1, 2018 Accepting new patients
McLaren Health Management Group CurrentSince Jan 6, 2025 Accepting new patients
McLaren Health Management Group Current Accepting new patients
McLaren Health Management Group Current Accepting new patients

Locations

1515 Cal Dr
Davison, MI 48423
Phone (810) 496-8640

3270 W Silver Lake Rd
Fenton, MI 48430
Phone (810) 208-7765

4000 S Saginaw St
Flint, MI 48507
Phone (810) 396-5700

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Organizations & group practices 4

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 3

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": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526256000000",
    "number": "1952720583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-2255",
            "fax_number": "336-716-3202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STONY BROOK UNIVERSITY HOSPITAL",
            "address_2": "MEDICAL/HOUSE STAFF SERVICES",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117947097",
            "telephone_number": "631-444-8413",
            "fax_number": "631-706-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLDREN",
        "first_name": "DANIEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-10",
        "last_updated": "2018-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NC",
            "license": "2018-00005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.