Individual provider Active NPI

Alexander Stetsyuk, MD

  • Diagnostic Radiology Physician
  • Concord, NH
National Provider Identifier
1043659790
Registry record updated Jul 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
20665 Issued in NH
Practice address
248 Pleasant St
Concord, NH 03301-2588
Phone
(603) 228-1521
Fax
(603) 225-2510
NPI assigned
Jun 17, 2013
Last updated
Jul 27, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2020

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 20665 NH Primary

Addresses

Primary practice location

248 Pleasant St
Concord, NH 03301-2588

Mailing address

55 Lake Avenue North
Worcester, MA 01655
Phone (508) 334-1000

Other practice location 1

250 Pleasant St
Concord, NH 03301-7559
Phone (603) 228-1521

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20200818003170 NH Practitioner - Diagnostic Radiology 9234465535 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Jefferson Medical College of Thomas Jefferson University, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Concord Imaging CenterGroup PAC ID 2466448030, 20 clinicians
X-Ray Professional AssociationGroup PAC ID 3375539927, 62 clinicians

Practice addresses (Care Compare)

248 Pleasant St
Concord, NH 03301-2588
Phone (603) 228-1521

250 Pleasant St
Concord, NH 03301-7559
Phone (603) 225-2711

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.6 of 100Reported as group
Quality
80.71
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
92.3 of 100Reported as group
Quality
90.94
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20665NHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Imaging Center Diagnostic Radiology CurrentSince Jul 27, 2020 Accepting new patients
X-Ray Professional Association Diagnostic Radiology CurrentSince Jul 27, 2020 Accepting new patients
Concord Hospital, Inc. Past Accepting new patients
Anesthesia Associates Professional Association PastSince Jul 27, 2020 Accepting new patients

Locations

248 Pleasant St
Concord, NH 03301
Phone (603) 224-4003

248 Pleasant St
Ste 102
Concord, NH 03301

250 Pleasant St
Concord, NH 03301
Phone (603) 225-2711

60 Commercial St
Concord, NH 03301
Phone (603) 415-9444

60 Commercial St
Ste 102
Concord, NH 03301
Phone (603) 230-1200

15 Aiken Ave
Franklin, NH 03235
Phone (603) 934-2060

14 Maple St
Ste 100
Gilford, NH 03249
Phone (603) 524-4220

14 Maple St
Ste 200
Gilford, NH 03249
Phone (603) 524-7514

724 N Main St
Laconia, NH 03246
Phone (603) 524-5151

734 N Main St
Laconia, NH 03246
Phone (603) 527-1855

80 Highland St
Laconia, NH 03246
Phone (603) 527-7100

238 Daniel Webster Hwy
Meredith, NH 03253
Phone (603) 279-7464

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1043659790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 LAKE AVENUE NORTH",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01655",
            "telephone_number": "508-334-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 PLEASANT ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033012588",
            "telephone_number": "603-228-1521",
            "fax_number": "603-225-2510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Pleasant St",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NH",
            "postal_code": "033017559",
            "country_code": "US",
            "telephone_number": "603-228-1521",
            "fax_number": "603-225-2510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STETSYUK",
        "first_name": "ALEXANDER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-17",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NH",
            "license": "20665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NH

Sources for this page

Verify at the official NPI Registry.