Individual provider Active NPI

Bruce R. Javors, M.D.

  • Diagnostic Radiology Physician
  • New York, NY
National Provider Identifier
1104854165
Registry record updated Aug 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
1221901 Issued in NY
Practice address
63 E 9TH St
New York, NY 10003-6302
Phone
(212) 505-7291
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2008

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 1221901 NY Primary

Addresses

Primary practice location

63 E 9TH St
New York, NY 10003-6302

Mailing address

63 E 9TH St
New York, NY 10003-6302
Phone (212) 505-7291

Other identifiers 1

IdentifierTypeStateIssuer
559115MedicaidNM

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
122190NYMDSocial Worker
1221901NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Winthrop Radiology Associates PC Diagnostic Radiology Past Accepting new patients
Saint Vincents Hospital and Medical Center Diagnostic Radiology Past Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients
Nyumc Radiology Associates Diagnostic Radiology Past Accepting new patients
New York University Medical Center Faculty Practice Radiology Diagnostic Radiology Past Accepting new patients

Organizations & group practices 5

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219968000000",
    "number": "1104854165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 E 9TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100036302",
            "telephone_number": "212-505-7291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 E 9TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100036302",
            "telephone_number": "212-505-7291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVORS",
        "first_name": "BRUCE",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2008-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "1221901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "559115",
            "state": "NM"
        }
    ],
    "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 Aug 29, 2008; 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.