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

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: August 16, 2026.

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

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 is a graduate of Other (2013).

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
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.
101 NICOLLS RD, Stony Brook, NY 11794

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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.

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
Quality82.85
Promoting Interoperability100
Improvement Activities40

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.

Internal Medicine
101 NICOLLS RD
STONY BROOK, NY 11794
Internal Medicine (Gastroenterology)
101 NICOLLS RD
STONY BROOK, NY 11794
Social Worker (Clinical)
101 NICOLLS RD
STONY BROOK, NY 11794
Nurse Practitioner (Adult Health)
101 NICOLLS RD
STONY BROOK, NY 11794
Nurse Practitioner (Adult Health)
101 NICOLLS RD
STONY BROOK, NY 11794
Student in an Organized Health Care Education/Training Program
101 NICOLLS RD
STONY BROOK, NY 11794
Student in an Organized Health Care Education/Training Program
101 NICOLLS RD
STONY BROOK, NY 11794
Student in an Organized Health Care Education/Training Program
101 NICOLLS RD
STONY BROOK, NY 11794

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 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.

Where is Sonya Marcus located?

Sonya Marcus practices at 101 Nicolls Rd, Stony Brook, NY 11794. The listed phone number is (917) 232-8062.

What is Sonya Marcus's specialty?

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

Is Sonya Marcus enrolled in Medicare?

Yes. Sonya Marcus is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Sonya Marcus affiliated with any hospitals?

According to CMS data, Sonya Marcus is affiliated with Suny/Stony Brook University Hospital.

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.