DR. JEREMY FERTEL MD NPI 1285020628

NPI Information

NPI: 1285020628
Provider Name: DR. JEREMY FERTEL, MD
Classification: Internal Medicine - 207RC0000X
Entity Type: Individual

Specialization: Cardiovascular Disease

Organization: STONY BROOK INTERNISTS UNIVERSITY FACULTY PRACTICE CORPORATION

PECOS Registration: Yes

Address:
1320 STONY BROOK RD STE 100
STONY BROOK, NY
ZIP 11790
Phone: (631) 941-2273
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DR. Jeremy Fertel, MD is a cardiovascular disease internal medicine in Stony Brook, NY with 9 years of experience. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. DR. Jeremy Fertel, MD NPI is 1285020628. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1320 STONY BROOK RD STE 100
STONY BROOK, NY
ZIP 11790-222
Phone: (631) 941-2273

The NPI 1285020628 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/13/2015 and was last updated on 10/12/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	390200000X	Student in an Organized Health Care Education/Training Program				No
2	207RC0000X	Internal Medicine	Cardiovascular Disease	307344-01	NEW YORK	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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