DR. JONATHAN PHILIP MINTZER (NPI# 1902096852) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902096852 |
| Entity Type | Individual |
| Full Name | DR. JONATHAN PHILIP MINTZER |
| Credential | MD |
| Practice Address |
Stony Brook University Medical Ctr Hsc T-11, Room 020 Stony Brook NY 11794-8111 |
| Practice Telephone | 6314447653 |
| Mailing Telephone | 6314447653 |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2012-06-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 240685 | NY | Allopathic & Osteopathic Physicians |
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
240685 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
STONY BROOK UNIVERSITY MEDICAL CTR HSC T-11, ROOM 020 |
| City | STONY BROOK |
| State | NY |
| Zip Code | 11794-8111 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508847302 | Margaret N Melendez | Nurse Practitioner | Stony Brook University Medical Ctr, Department of Medicine L16, Stony Brook, NY 11794-0001 | 2005-11-09 |
| 1447705736 | Xiaoyun Wen | Student in an Organized Health Care Education/Training Program | Stony Brook University Medical Ctr, Department of Pathology, Level 2, Stony Brook, NY 11794-7025 | 2016-08-17 |
| 1619325545 | Dhruti Patel | Student in an Organized Health Care Education/Training Program | Stony Brook University Medical Ctr, Hsc T-10, Room 020, Stony Brook, NY 11794-0001 | 2016-06-01 |
| 1699120147 | Jill Marie-faye Ludin | Student in an Organized Health Care Education/Training Program | Stony Brook University Medical Ctr, Hsc T-10, Room 020, Stony Brook, NY 11794-8101 | 2016-05-03 |
| 1740644475 | Laura Andreski | Student in an Organized Health Care Education/Training Program | Stony Brook University Medical Ctr, Hsc T-10, Room 020, Stony Brook, NY 11794-0001 | 2016-04-08 |
| 1093178170 | Michael Robert Bisogno | Student in an Organized Health Care Education/Training Program | Stony Brook University Medical Ctr, Department of Orthopaedics, Hsc T-18, Stony Brook, NY 11794-8181 | 2016-04-05 |
| 1558723924 | Ben Joseph | Student in an Organized Health Care Education/Training Program | Stony Brook University Medical Ctr, Department of Orthopedics, Hsc T-18, Stony Brook, NY 11794-8181 | 2016-03-24 |
| 1821477704 | Katherine Pan | Student in an Organized Health Care Education/Training Program | Stony Brook University Medical Ctr, Hsc T-10, Room 020, Stony Brook, NY 11794-8101 | 2015-05-25 |
| 1992184303 | Sean Alyeshmerni | Student in an Organized Health Care Education/Training Program | Stony Brook University Medical Ctr, Hsc T-10 Room 020, Stony Brook, NY 11794-8101 | 2015-05-19 |
| 1497133813 | Jisoo Park | Psychiatry & Neurology | Stony Brook University Medical Ctr, Department of Psychiatry Hsc T-10, Rm 020, Stony Brook, NY 11794-8101 | 2015-05-18 |
| 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 | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255562419 | Daniela Matias Feitosa Titchiner | Pediatrics | Hsc T11, Room 040, Stony Brook, NY 11794-8111 | 2009-08-05 |
| 1750558623 | Echezona Maduekwe | Pediatrics | 100 Nicolls Rd Rm 60, Department of Pediatrics, Stony Brook, NY 11794-8111 | 2008-05-10 |
| 1497826580 | Dennis Davidson | Pediatrics | Stony Brook Long Island Childrens Hospital, Hsc 11 Room 060, Stony Brook, NY 11794-8552 | 2006-11-13 |
| 1801835236 | Shanthy Sridhar | Pediatrics | University Hospital, L8, Stony Brook, NY 11794-0001 | 2006-06-04 |
| 1285952952 | Shahriar Mokrian | Pediatrics | Stony Brook University Hospital, Medical Staff Office T9, Stony Brook, NY 11794-7097 | 2010-05-05 |
| 1194042531 | Carly Isabel Gomes | Pediatrics | 101 Nicolls Rd, Hsc T11 Room 060, Stony Brook, NY 11794 | 2010-04-26 |
| 1548404254 | Surabhi Aggarwal | Pediatrics | Stony Brook University Hospital, Medical Staff Office T14, Stony Brook, NY 11794-7148 | 2009-04-24 |
| 1225290182 | John Joseph Tadros | Pediatrics | Stony Brook University Hospital, Dept of Pediatrics, Division of Neonatology,hsc,t11,060, Stony Brook, NY 11794-7148 | 2008-07-01 |
| 1881637700 | Joseph Decristofaro | Pediatrics | 100 Nicolls Rd, Stony Brook Hospital, Stony Brook, NY 11794-8111 | 2006-06-14 |
| 1922046473 | Jila Sharif | Pediatrics | University Hospital, L8, Stony Brook, NY 11794-0001 | 2006-06-04 |
| Find all providers in STONY BROOK | ||||
| City | STONY BROOK |
| Zip Code | 11794 |
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| 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.