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JOHN PATRICK STOUTENBURG MD NPI 1306834411


NPI Information

NPI: 1306834411
Provider Name: JOHN PATRICK STOUTENBURG, MD
Classification: Internal Medicine - 207RH0003X
Entity Type: Individual

Specialization: Hematology & Oncology

PECOS Registration: Yes

Address:
100 PARK ST
CR WOOD CANCER CENTER
GLENS FALLS, NY
ZIP 12801
Phone: (518) 926-6620
Get Directions

John Patrick Stoutenburg, MD is a hematology and oncology internal medicine in Glens Falls, NY with 25 years of experience. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. John Patrick Stoutenburg, MD NPI is 1306834411. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: STATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
Graduation Year:1999

The provider's business location address is:

100 PARK ST
CR WOOD CANCER CENTER
GLENS FALLS, NY
ZIP 12801-413
Phone: (518) 926-6620
Fax: (518) 926-1954

The NPI 1306834411 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 10/12/2005 and was last updated on 6/29/2021.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RH0003XInternal MedicineHematology & Oncology225232NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
102667792MEDICAIDNEW YORK
2P00248124OTHERNEW YORKRR MEDICARE

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.