NPIMap

Organization Active NPI

Stand-Up MRI of Bensonhurst, PC

  • Diagnostic Radiology Physician
  • Brooklyn, NY
National Provider Identifier
1093780058
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
STAND-UP MRI OF BENSONHURST, PC
Practice address
2671 86TH St
Brooklyn, NY 11223-3506
Phone
(718) 946-7304
Fax
(718) 946-7308
NPI assigned
Feb 22, 2006
Last updated
Jun 9, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

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

Authorized official

Name
Lloyd Waxman
Title
Director of Operations
Phone
(631) 694-2816

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

2671 86TH St
Brooklyn, NY 11223-3506

Mailing address

2671 86TH St
Brooklyn, NY 11223-3506
Phone (718) 946-7304

Other identifiers 1

IdentifierTypeStateIssuer
02916452MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040317001425 NY Part B Supplier - Clinic/Group Practice 6002706637 Receives reassigned benefits from 20 practitioners
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1093780058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2671 86TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112233506",
            "telephone_number": "718-946-7304",
            "fax_number": "718-946-7308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2671 86TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112233506",
            "telephone_number": "718-946-7304",
            "fax_number": "718-946-7308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAND-UP MRI OF BENSONHURST, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-22",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "WAXMAN",
        "authorized_official_first_name": "LLOYD",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "631-694-2816"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02916452",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.