SONYA MARCUS M.D.
NPI 1437594058
Otolaryngology in Stony Brook, NY

Q: What is Sonya Marcus's NPI number?

The NPI number for Sonya Marcus is 1437594058. It was assigned to this individual provider in the NPPES registry on May 9, 2013.

Q: What is Sonya Marcus's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Q: When was this NPI record last updated?

The NPPES record for Sonya Marcus was last updated on April 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since May 09, 2013PECOS EnrolledAccepts Medicare Assignment

98.52/100

CMS Quality Rating

101 NICOLLS RD, STONY BROOK, NY 11794(917) 232-8062 Get Directions Write a Review

NPPES record last updated: April 14, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 14, 2022, Jul 12, 2018 (2 updates tracked since 2018).

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About Sonya Marcus M.d. NPPES

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

SONYA MARCUS M.D. (NPI 1437594058) is an individual otolaryngology provider in Stony Brook, New York, licensed in Georgia (80303) and active in the NPI registry since May 2013. She is enrolled in Medicare PECOS, is affiliated with Suny/stony Brook University Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1437594058

Entity TypeIndividualFemale

Primary Taxonomy207Y00000X

Provider Legal NameSONYA MARCUSCredential: M.D.

Location Address101 NICOLLS RDStony Brook, NY 11794-0001

Mailing Address550 Peachtree St Ne Ste 1135Atlanta, GA 30308-2234 · (404) 778-3381

Phone(917) 232-8062

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateMay 9, 2013

Last NPPES UpdateApril 14, 20222 updates tracked since enumeration

NPPES CertifiedApril 14, 2022

✔ NPI 1437594058 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians

Taxonomy Code207Y00000X

License✔ Licensed in GA · 80303

Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

101 NICOLLS RD, Stony Brook, NY 11794

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Secondary Practice Locations 2

Location 1550 1st Ave, NYU Langone Medical CenterNew York, NY 10016-6402 · Phone (212) 263-5506

Location 2550 Peachtree St NE Ste 1135Atlanta, GA 30308 · Phone (917) 232-8062

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Sonya Marcus M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9133479637

PECOS Enrollment IDI20190916001043

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Sonya Marcus reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Stony Brook Surgical Associates, University Faculty Practice Corporati

0.5 mi

Surgery

SUNY @ STONY BROOK, HSC, L19, RM 020
Stony Brook, NY 11794

Reassigned Medicare billing, New York enrollment
114 clinicians in this Medicare group

NPI 1063468536 (631) 444-8278

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

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Diagnostic exam of nasal passages using an endoscope 31231

A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.

284 services219 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

119 services92 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

107 services107 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

96 services72 patients

Control of bleeding of nose using an endoscope 31238

This is a procedure where an endoscope, a thin tube with a light and camera, is used to view inside your nose. This allows the doctor to locate the source of the bleeding and control it, often by cauterization or packing the nose.

48 services39 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

48 services48 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Suny/Stony Brook University Hospital

Acute Care Hospitals · Stony Brook, NY

4/5 CMS rating

OwnershipGovernment - State

CMS Certification Number330393

LocationHealth Sciences Center SunyStony Brook, NY 11794 · Suffolk County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11794 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$154.28 typical visit price

range $67.40 – $203.53

Typical copayment $38.57 (range $16.85 – $50.88)

Most-billed visit code 99204

Established Patient

$83.44 typical visit price

range $21.66 – $164.45

Typical copayment $20.86 (range $5.41 – $41.11)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

98.52/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

82.85

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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