NPIMap

Organization Active NPI

Regional Imaging & Therapeutic Radiology Services PC

  • Diagnostic Radiology Physician
  • Staten Island, NY
National Provider Identifier
1023095445
Registry record updated Apr 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
REGIONAL IMAGING & THERAPEUTIC RADIOLOGY SERVICES PC
Practice address
360 Bard Ave
Staten Island, NY 10310-1666
Phone
(718) 876-2000
Fax
(718) 876-2006
NPI assigned
Dec 28, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2011

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

Authorized official

Name
Dr. Matthew J Stern, M.D.
Title
President
Phone
(718) 876-2000

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207U00000X
Radiation Oncology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0001X
Diagnostic Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

360 Bard Ave
Staten Island, NY 10310-1666

Mailing address

360 Bard Ave
Staten Island, NY 10310-1666
Phone (718) 876-2000

Other identifiers 1

IdentifierTypeStateIssuer
01127802MedicaidNY

Other names 1

  • Regional Radiology Doing business as

National Provider Directory

National Provider Directory

Locations

4849 Arthur Kill Rd
#P
Staten Island, NY 10309
Phone (718) 876-2000

1050 Targee St
Staten Island, NY 10304
Phone (718) 226-2191

3917 Richmond Ave
Staten Island, NY 10312
Phone (718) 876-2000

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303344000000",
    "number": "1023095445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 BARD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103101666",
            "telephone_number": "718-876-2000",
            "fax_number": "718-876-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 BARD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103101666",
            "telephone_number": "718-876-2000",
            "fax_number": "718-876-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGIONAL IMAGING & THERAPEUTIC RADIOLOGY SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-28",
        "last_updated": "2011-04-21",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-876-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nuclear Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01127802",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regional Radiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.