Active NPI
Central Nassau Diagnostic Imaging
- Diagnostic Radiology Physician
- Rego Park, NY
National Provider Identifier
1114185048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 179224
- Legal business name
- CENTRAL NASSAU DIAGNOSTIC IMAGING
- Practice address
- 6555 Woodhaven Blvd
Rego Park, NY 11374-5048 - Phone
- (718) 731-2500
- Fax
- (718) 731-2502
- NPI assigned
- May 28, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Allen Rothpearl, MD
- Title
- Medical Director
- Phone
- (516) 527-5148
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 179224 | NY | Primary |
Addresses
Primary practice location
6555 Woodhaven Blvd
Rego Park, NY 11374-5048
Mailing address
6555 Woodhaven Blvd
Rego Park, NY 11374-5048
Phone (718) 731-2500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01626879 | Medicaid | NY |
National Provider Directory
National Provider Directory- Tax ID family
- Central Nassau Diagnostic
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba central nassau diagnostic
- Exclusive Provider Organization
- East Meadow, NY
- NPI 1891882585
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211932800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1211932800000",
"number": "1114185048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6555 WOODHAVEN BLVD",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113745048",
"telephone_number": "718-731-2500",
"fax_number": "718-731-2502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6555 WOODHAVEN BLVD",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113745048",
"telephone_number": "718-731-2500",
"fax_number": "718-731-2502"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CENTRAL NASSAU DIAGNOSTIC IMAGING",
"organizational_subpart": "NO",
"enumeration_date": "2008-05-28",
"last_updated": "2008-05-28",
"status": "A",
"authorized_official_last_name": "ROTHPEARL",
"authorized_official_first_name": "ALLEN",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "516-527-5148",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": "NY",
"license": "179224",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01626879",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rego Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.