Individual provider Active NPI

Alexandra B Perkins, M.D.

  • Diagnostic Radiology Physician
  • Lake Grove, NY
National Provider Identifier
1033169404
Registry record updated Feb 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
206296 Issued in NY
Practice address
2780 Middle Country Rd
Suite 210
Lake Grove, NY 11755-2124
Phone
(631) 588-4500
Fax
(631) 588-4595
NPI assigned
May 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 206296 NY Primary

Addresses

Primary practice location

2780 Middle Country Rd
Suite 210
Lake Grove, NY 11755-2124

Mailing address

2780 Middle Country Rd
Suite 210
Lake Grove, NY 11755-2124
Phone (631) 588-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041214001101 NY Practitioner - Diagnostic Radiology 1153388863 Reassigns benefits to 2 organizations
I20241226001833 WA Practitioner - Diagnostic Radiology 1153388863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Boston University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2780 Middle Country Rd
Suite 210
Lake Grove, NY 11755-2120
Phone (631) 588-4500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
206296NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Okanogan County Public Hospital Dist No 4 CurrentSince Dec 19, 2024 Accepting new patients
Suffolk Breast Imaging PC Diagnostic Radiology CurrentSince Feb 15, 2005 Accepting new patients
Radia Inc P S Diagnostic Radiology CurrentSince Feb 5, 2024 Accepting new patients
Okanogan County Public Hospital Dist No 4 Current Accepting new patients
Port Interventional Radiology PC Diagnostic Radiology Past Accepting new patients
Radiology Health Services, PC Diagnostic Radiology Past Accepting new patients
Okanogan County Public Hospital Dist No 4 Past Accepting new patients
Okanogan County Public Hospital Dist No 4 Past Accepting new patients
Port Radiation Therapy PC Diagnostic Radiology Past Accepting new patients
Mount Sinai School of Medicine Past Accepting new patients

Locations

2780 Middle Country Rd
Ste 210
Lake Grove, NY 11755
Phone (631) 588-4500

203 S Western Ave
Tonasket, WA 98855
Phone (509) 486-2151

Organizations & group practices 10

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

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266278400000",
    "number": "1033169404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 MIDDLE COUNTRY RD",
            "address_2": "SUITE 210",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117552124",
            "telephone_number": "631-588-4500",
            "fax_number": "631-588-4595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 MIDDLE COUNTRY RD",
            "address_2": "SUITE 210",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117552124",
            "telephone_number": "631-588-4500",
            "fax_number": "631-588-4595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERKINS",
        "first_name": "ALEXANDRA",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2010-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "206296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Grove, NY

Sources for this page

Verify at the official NPI Registry.