Individual provider Active NPI

Dattatretydu Nori, M.D.

  • Radiation Oncology Physician
  • New York, NY
National Provider Identifier
1003920273
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
138850 Issued in NY
Practice address
525 E 68TH St
N046
New York, NY 10021-4870
Phone
(212) 746-3141
Fax
(212) 746-8749
NPI assigned
Aug 18, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 138850 NY Primary

Addresses

Primary practice location

525 E 68TH St
N046
New York, NY 10021-4870

Mailing address

575 Lexington Ave
Suite 500
New York, NY 10022-6102
Phone (212) 590-5152

Other identifiers 1

IdentifierTypeStateIssuer
01126998MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101202000963 NY Practitioner - Radiation Oncology 6103013198 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
138850NYMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell CurrentSince Aug 16, 1996 Accepting new patients
Weill Medical College of Cornell Current Accepting new patients
Weill Medical College of Cornell Current Accepting new patients
Weill Medical College of Cornell Current Accepting new patients
Weill Medical College of Cornell Radiation Oncology CurrentSince Aug 16, 1996 Accepting new patients
Weill Medical College of Cornell Radiation Oncology CurrentSince Jul 1, 2002 Accepting new patients

Locations

5645 Main St
Flushing, NY 11355
Phone (718) 670-1435

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

525 E 68th St
#585
New York, NY 10065
Phone (212) 746-2059

525 E 68th St
#N
New York, NY 10065
Phone (212) 207-3275

525 E 68th St
#N46
New York, NY 10065
Phone (212) 746-3141

575 Lexington Ave
Ste 500
New York, NY 10022
Phone (212) 590-5151

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1003920273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 LEXINGTON AVE",
            "address_2": "SUITE 500",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100226102",
            "telephone_number": "212-590-5152",
            "fax_number": "212-590-5798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E 68TH ST",
            "address_2": "N046",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214870",
            "telephone_number": "212-746-3141",
            "fax_number": "212-746-8749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORI",
        "first_name": "DATTATRETYDU",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NY",
            "license": "138850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01126998",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.