NEW YORK SPINE & BRAIN SURGERY, UNIVERSITY FACULTY PRACTICE CORPORATIO (NPI# 1154376309) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154376309 |
| Entity Type | Organization |
| Organization Name | NEW YORK SPINE & BRAIN SURGERY, UNIVERSITY FACULTY PRACTICE CORPORATIO |
| Practice Address |
Suny @ Stony Brook Hsc, L12, Rm 080 Stony Brook NY 11794-0001 |
| Mailing Address |
Po Box 1554 Stony Brook NY 11790-0988 |
| Practice Telephone | 6314441116 |
| Mailing Telephone | 6314441116 |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2015-10-06 |
| Authorized Official Name | RAPHAEL P. DAVIS (CHAIR PERSON) |
| Authorized Official Telephone | 6314441116 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00778285 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | NEW YORK SPINE & BRAIN SURGERY, UNIVERSITY FACULTY PRACTICE CORPORATION | Health Sciences Ctr L5 Rm 048, Stony Brook University, Stony Brook, New York 11794 |
| Street Address |
SUNY @ STONY BROOK HSC, L12, RM 080 |
| City | STONY BROOK |
| State | NY |
| Zip Code | 11794-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982659470 | Stony Brook Family and Preventive Medicine, University Faculty Practic | Family Medicine | Suny @ Stony Brook, Hsc, L4, Rm 050, Stony Brook, NY 11794-0001 | 2006-05-23 |
| 1295778371 | Stony Brook Internists, University Faculty Practice Corporation | Internal Medicine | Suny @ Stony Brook, Hsc, L16, Rm 020, Stony Brook, NY 11794-0001 | 2006-06-14 |
| 1578502100 | Stony Brook Internists, University Faculty Practice Corporation | Internal Medicine | Suny @ Stony Brook, Hsc, L16, Rm 020, Stony Brook, NY 11794-0001 | 2006-06-06 |
| 1265471809 | Stony Brook Internists, University Faculty Practice Corporation | Internal Medicine | Suny @ Stony Brook, Hsc, L16, Rm 020, Stony Brook, NY 11794-0001 | 2006-06-06 |
| 1497794077 | Stony Brook Internists, University Faculty Practice Corporation | Internal Medicine | Suny @ Stony Brook, Hsc, L16, Rm 020, Stony Brook, NY 11794-0001 | 2006-06-06 |
| 1659310241 | Stony Brook Internists, University Faculty Practice Corporation | Internal Medicine | Suny @ Stony Brook, Hsc, L16, Rm 020, Stony Brook, NY 11794-0001 | 2006-06-06 |
| 1215976337 | Stony Brook Internists, University Faculty Practice Corporation | Internal Medicine | Suny @ Stony Brook, Hsc, L16, Rm 020, Stony Brook, NY 11794-0001 | 2006-06-05 |
| 1104865229 | Stony Brook Internists, University Faculty Practice Corporation | Internal Medicine | Suny @ Stony Brook, Hsc, L16, Rm 020, Stony Brook, NY 11794-0001 | 2006-06-05 |
| 1356380471 | Stony Brook Internists, University Faculty Practice Corporation | Internal Medicine | Suny @ Stony Brook, Hsc, L16, Rm 020, Stony Brook, NY 11794-0001 | 2006-06-05 |
| 1912944794 | Stony Brook Pathologists, University Faculty Practice Corporation | Pathology | Suny @ Stony Brook, Bhs, L9, Rm 140, Stony Brook, NY 11790 | 2006-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619506714 | Ryan John Kottmeier | Physician Assistant | 101 Nicolls Road Suny Stony Brook Hospital, Dept of Orthopedics Hsc T18, Room 080, Stony Brook, NY 11794 | 2020-04-02 |
| 1699302109 | Michael Trentalange | Student in an Organized Health Care Education/Training Program | Department of Surgery, Health Sciences Center Level 19, Room 030, Stony Brook, NY 11794 | 2020-03-25 |
| 1164985156 | Lauren Kate Harris | Student in an Organized Health Care Education/Training Program | Stony Brook Medicine, Department of Ob/gyn, Hsc T9, 101 Nicolls Road, Stony Brook, NY 11794 | 2019-04-08 |
| 1851851448 | Kathy Tin | Student in an Organized Health Care Education/Training Program | Dept of Medicine Hsc 16 Suny Stony Brook Hospital, Stony Brook, NY 11794 | 2019-03-21 |
| 1174083703 | Arham Khan | Student in an Organized Health Care Education/Training Program | Dept of Medicine Hsc Level 16, Suny Stony Brook Hosp, Stony Brook, NY 11794 | 2019-03-20 |
| 1396221982 | Aman Bhojani | Student in an Organized Health Care Education/Training Program | Suny At Stony Brook Dental School, South Drive, Stony Brook, NY 11794 | 2018-07-17 |
| 1699265629 | Belliny Phaeton | Student in an Organized Health Care Education/Training Program | Stony Brook Children's Hospital, Hsc T-11, Room 040, Stony Brook, NY 11794 | 2018-05-15 |
| 1629568969 | Rachel Herold | Student in an Organized Health Care Education/Training Program | Stony Brook Children's Department of Pediatrics, Hsc T-11, Room 040, Stony Brook, NY 11794 | 2018-05-11 |
| 1598254419 | Nora Ann Diraimondo | Nurse Practitioner | Sb Hospital 101 Nicolls Road, Department of Medicine, Stony Brook, NY 11794 | 2018-05-07 |
| 1386140705 | Ryan Christopher Corn | Student in an Organized Health Care Education/Training Program | Dept. of Internal Medicine, Hsc Level 16-020, Suny Stony Brook, Stony Brook, NY 11794 | 2018-04-04 |
| Find all providers in zip 11794 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457814824 | Brain & Spine Surgery, P.C. | Neurological Surgery | 2500 Nesconset Hwy., Bldg 18c, Stony Brook, NY 11790 | 2019-04-11 |
| 1801167895 | Reza Dashti | Neurological Surgery | New York Spine and Brain Surgery Hsc T12 Rm 080, Stony Brook, NY 11794 | 2012-01-23 |
| 1467741884 | Courtney Pendleton | Neurological Surgery | 100 Nicholls Road Hsc T12 Rm 080, Stony Brook, NY 11794-0001 | 2011-04-06 |
| 1124254917 | Charles Bazemore Mikell IIi | Neurological Surgery | Hsc T12, Room 080, Stony Brook, NY 11794-8122 | 2009-06-07 |
| 1356682652 | Mark-mina M Ishak | Neurological Surgery | 2500 Nesconset Highway, Building 18c, Stony Brook, NY 11790 | 2013-03-12 |
| 1427345198 | Lissa Peeling | Neurological Surgery | Stony Brook University Medical Ctr, Hsc T12-rm 060, Stony Brook, NY 11794-8122 | 2011-07-01 |
| 1679718670 | Neuro Brain & Spine Surgery, P.C. | Neurological Surgery | 2500 Nesconset Hwy, Bldg. 18, Suite 69, Stony Brook, NY 11790-2555 | 2008-12-05 |
| 1669638540 | Magdy Shady Neurosurgeon PC | Neurological Surgery | 2500 Nesconset Hwy, Bldg 18c, Stony Brook, NY 11790-2555 | 2008-07-31 |
| 1073556437 | Magdy Shawky Shady | Neurological Surgery | 2500 Nesconset Hwy, Building 18c, Stony Brook, NY 11790-2555 | 2006-06-14 |
| 1982652848 | Henry H Woo | Neurological Surgery | 101 Nicolls Rd, Cv Center, Hosp Level 4, Rm 430, Stony Brook, NY 11794-7447 | 2006-05-04 |
| Find all providers in STONY BROOK | ||||
| City | STONY BROOK |
| Zip Code | 11794 |
Please comment or provide details below to improve the information on NEW YORK SPINE & BRAIN SURGERY, UNIVERSITY FACULTY PRACTICE CORPORATIO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.