Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1861190209 Individual Practitioner Female Practitioner

Stephanie Ida

Specialist • Patchogue, NY

Professional Overview & Biography Verified Profile Summary

Stephanie Ida is a registered healthcare professional specializing in Specialist in Patchogue, NY. Practice services are available at 20 BAILEY AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

20 Bailey Ave

Patchogue, NY 117723902

Telephone 6317904301

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Patchogue, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 43.0 Yrs
State Avg: 34.9 Yrs
Regional Practice Density
31 Specialists

Practicing in Patchogue, NY (23296 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-02-15
Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Specialist

NUCC Taxonomy Code: 174400000X

State License NY 447004921

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active February 15, 2023

NPI status registered as active in NPPES database

📍
Updated Practice Location February 15, 2023

Registered at 20 BAILEY AVE, PATCHOGUE, NY 117723902 (Tel: 6317904301)

📍
Updated Business Mailing Address February 15, 2023

Registered at 20 BAILEY AVE, PATCHOGUE, NY 117723902 (Tel: 6317904301)

👤
Provider Name / Credentials Updated February 15, 2023

Recorded as STEPHANIE IDA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 15, 2023

Specialist (License #447004921 in NY)

🟢
Initial NPI Registration & Enumeration February 15, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1861190209
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 15, 2023
Last Update: February 15, 2023
Sole Proprietor: No

Mailing Address

20 Bailey Ave

Patchogue, NY 117723902

Phone: 6317904301

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.