Organization Active NPI

Radiance Medicine LLC

  • Vascular & Interventional Radiology Physician
  • Brooklyn, NY
National Provider Identifier
1124632039
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
RADIANCE MEDICINE LLC
Practice address
95 Norman Ave
Brooklyn, NY 11222-2937
Phone
(516) 851-4211
NPI assigned
Sep 8, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Authorized official

Name
Benjamin YamNPI 1962716480
Title
MD
Phone
(516) 851-4211

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0204X Primary

Addresses

Primary practice location

95 Norman Ave
Brooklyn, NY 11222-2937

Mailing address

168 Overlook Ter
Roslyn Heights, NY 11577-1438

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1599523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647388800000",
    "number": "1124632039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 OVERLOOK TER",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115771438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 NORMAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112222937",
            "telephone_number": "516-851-4211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIANCE MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-08",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A",
        "authorized_official_last_name": "YAM",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "516-851-4211"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 16, 2022; 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.