STONY BROOK PRIMARY CARE LLC
NPI 1790945160
Internal Medicine in North Chelmsford, MA
About Stony Brook Primary Care Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
STONY BROOK PRIMARY CARE LLC (NPI 1790945160) is a healthcare organization registered as an internal medicine in North Chelmsford, Massachusetts and active in the NPI registry since June 2008. The organization holds a CLIA Waiver certificate valid through April 22, 2027 and lists Jessica Wieselquist, Owner/provider, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Stony Brook Primary Care Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Stony Brook Primary Care LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
North Chelmsford, MA 01863
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 22D1098600
Stony Brook Primary Care · North Chelmsford, MAFrequently 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 Stony Brook Primary Care LLC's NPI number?
The NPI number for Stony Brook Primary Care LLC is 1790945160. It was assigned to this organization in the NPPES registry on June 10, 2008.
Where is Stony Brook Primary Care LLC located?
Stony Brook Primary Care LLC is located at 20 Research Pl Suite 100, North Chelmsford, MA 01863. The listed phone number is (978) 446-9850.
What is Stony Brook Primary Care LLC's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Stony Brook Primary Care LLC enrolled in Medicare?
Yes. Stony Brook Primary Care LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Stony Brook Primary Care LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Stony Brook Primary Care LLC, in Internal Medicine and Nurse Practitioner. 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. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Stony Brook Primary Care LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 22D1098600) is associated with this NPI, valid through April 22, 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 Stony Brook Primary Care LLC was last updated on July 31, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Stony Brook Primary Care Llc · NPI 1790945160
Internal Medicine organization in North Chelmsford, Massachusetts. Organization record, active in the CMS NPPES registry since June 10, 2008.
## Identity
- **NPI:** 1790945160 (Entity type: Organization)
- **Enumerated:** June 10, 2008
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Organization subpart:** No
- **Authorized official:** Jessica Wieselquist, OWNER/PROVIDER
## Practice location
- **Address:** 20 RESEARCH PL, SUITE 100, North Chelmsford, MA 01863-2454
- **Phone:** (978) 446-9850 · **Fax:** (855) 283-4714
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Internal Medicine (1), Nurse Practitioner (1); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 31, 2017
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1790945160) · Data from the CMS NPPES public registry.