Individual provider Active NPI

Jose Luis Ferreira Sr., RT

  • Mobile Radiology Clinic/Center
  • New York, NY
National Provider Identifier
1063470920
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X
License
626344 Issued in NJ
Practice address
5 Hamilton PL
New York, NY 10031-6801
Phone
(908) 884-0616
Fax
(908) 634-4797
NPI assigned
May 2, 2006
Last updated
Oct 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mobile Radiology Clinic/Center 261QR0208X 092842 NY
Mobile Radiology Clinic/Center 261QR0208X 626344 NJ Primary

Addresses

Primary practice location

5 Hamilton PL
New York, NY 10031-6801

Mailing address

50 S Michigan Ave
Kenilworth, NJ 07033-1739
Phone (888) 964-0088

Other identifiers 1

IdentifierTypeStateIssuer
0064432MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
626344NJMDMobile Radiology Clinic/Center
092842NYMDMobile Radiology Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Mobile Radiology Radiology, Mobile CurrentSince Oct 5, 2025 Accepting new patients

Organizations & group practices 1

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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1063470920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 S MICHIGAN AVE",
            "city": "KENILWORTH",
            "state": "NJ",
            "postal_code": "070331739",
            "telephone_number": "888-964-0088",
            "fax_number": "917-634-4797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 HAMILTON PL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100316801",
            "telephone_number": "908-884-0616",
            "fax_number": "908-634-4797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERREIRA",
        "first_name": "JOSE",
        "middle_name": "LUIS",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "RT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "NY",
            "license": "092842",
            "primary": false
        },
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "NJ",
            "license": "626344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0064432",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2025; 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.