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EDRA STERN MD LLC
NPI 1184124075
Internal Medicine in Old Greenwich, CT

Active since February 16, 2018CLIA 07D2126562 · Waiver
1455 EAST PUTNAM AVE, 2ND FLOOR, OLD GREENWICH, CT 06870(203) 661-4242(203) 625-9626 Get Directions Write a Review

NPPES record last updated: February 16, 2018. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Edra Stern Md Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDRA STERN MD LLC (NPI 1184124075) is a healthcare organization registered as an internal medicine in Old Greenwich, Connecticut and active in the NPI registry since February 2018. The organization holds a CLIA Waiver certificate valid through February 28, 2027 and lists Edra Stern, Physician / Owner, as its authorized official.

NPPES Registry Identity

NPI1184124075
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameEDRA STERN MD LLC
Location Address1455 EAST PUTNAM AVE, 2ND FLOOROld Greenwich, CT 06870-1360
Mailing Address1455 East Putnam Ave, 2nd FloorOld Greenwich, CT 06870-1360 · (203) 661-4242 · Fax (203) 625-9626
Phone(203) 661-4242
Fax(203) 625-9626
Organization SubpartNo
Authorized OfficialEdra SternPhysician / Owner · (203) 661-4242
Enumeration DateFebruary 16, 2018
✔ NPI 1184124075 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1455 EAST PUTNAM AVE, Old Greenwich, CT 06870
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Edra Stern Md Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Edra Stern MD LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Edra Stern, MD
Internal Medicine
NPI 1164624557
1455 E PUTNAM AVE STE 2
Old Greenwich, CT 06870
(203) 661-4242
✔ PECOS✔ Accepts Medicare0.1 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 07D2126562

Edra Stern MD LLC · Old Greenwich, CT
Active · expires Feb 28, 2027
CLIA Number07D2126562
Laboratory TypePhysician Office
Certificate Effective DateMarch 1, 2025
Certificate Expiration DateFebruary 28, 2027
Laboratory DirectorEdra L. Stern
Laboratory Phone(203) 661-4242
Laboratory LocationEdra Stern MD LLC1455 East Putnam Ave, Old Greenwich, CT 06870
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edra Stern MD LLC's NPI number?

The NPI number for Edra Stern MD LLC is 1184124075. It was assigned to this organization in the NPPES registry on February 16, 2018.

Where is Edra Stern MD LLC located?

Edra Stern MD LLC is located at 1455 East Putnam Ave 2nd Floor, Old Greenwich, CT 06870. The listed phone number is (203) 661-4242.

What is Edra Stern MD LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Edra Stern MD LLC enrolled in Medicare?

Yes. Edra Stern MD LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Edra Stern MD LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Edra Stern MD LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Edra Stern MD LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 07D2126562) is associated with this NPI, valid through February 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Edra Stern MD LLC was last updated on February 16, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.