Individual provider Active NPI

Lale Kostakoglu Shields, MD

  • Nuclear Radiology Physician
  • Charlottesville, VA
National Provider Identifier
1154398642
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Radiology PhysicianTaxonomy code 2085N0904X
License
0101267678 Issued in VA
Practice address
1240 Lee St
Charlottesville, VA 22908-0817
Phone
(434) 924-9333
Fax
(434) 243-3938
NPI assigned
Mar 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Radiology Physician 2085N0904X 0101267678 VA Primary

Addresses

Primary practice location

1240 Lee St
Charlottesville, VA 22908-0817

Mailing address

PO Box 9007
Charlottesville, VA 22906-9007

Other practice location 1

1215 Lee St
Charlottesville, VA 22908-0816
Phone (434) 924-9400

Other names 1

  • Lale Kostakoglu Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lkostakoglushields446466@direct.healthsystem.virginia.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, VA, DC3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20060227000221 NY Practitioner - Nuclear MedicinePractitioner - Diagnostic Radiology 9133135387 Reassigns benefits to 4 organizations
I20200124001216 VA Practitioner - Nuclear Medicine 9133135387 Reassigns benefits to 3 organizations
I20250812002667 DC Practitioner - Diagnostic Radiology 9133135387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nuclear Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

1213 O St NW
Washington, DC 20005-4411
Phone (212) 263-5230

160 E 34TH St
New York, NY 10016-4744
Phone (212) 263-7300

297 Mineola Blvd
Mineola, NY 11501-1502
Phone (516) 294-1377

530 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

560 1St Ave
New York, NY 10016-6402
Phone (212) 263-7300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101267678VAMDNuclear Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Oct 1, 2023 Accepting new patients
University of Virginia Imaging, LLC CurrentSince Jan 1, 2023 Accepting new patients
University of Virginia Physicians Group CurrentSince Nov 26, 2019 Accepting new patients
Fpa Hospital Based Nuclear Medicine CurrentSince Jul 7, 2019 Accepting new patients
Fpa Hospital Based CurrentSince Jul 7, 2019 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine CurrentSince Dec 1, 2015 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine CurrentSince Dec 1, 2015 Accepting new patients
University of Virginia Imaging, LLC Current Accepting new patients
New York University Nuclear Medicine CurrentSince Oct 1, 2023 Accepting new patients
University of Virginia Imaging, LLC CurrentSince Jan 1, 2023 Accepting new patients
Mount Sinai School of Medicine Nuclear Medicine Past Accepting new patients

Locations

700 Hicksville Rd
Ste 205
Bethpage, NY 11714
Phone (646) 501-3325

325 Park Ave
Huntington, NY 11743
Phone (631) 351-3700

3712 82nd St
Jackson Hts, NY 11372
Phone (718) 879-1600

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

1470 Madison Ave
New York, NY 10029
Phone (212) 241-0806

1176 5th Ave
#1235
New York, NY 10029
Phone (212) 241-6381

13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

1240 Lee St
Charlottesville, VA 22908

1215 Lee St
Charlottesvle, VA 22908
Phone (434) 924-0211

545 Ray C Hunt Dr
Ste 140
Charlottesvle, VA 22903
Phone (434) 243-9198

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: lkostakoglushields446466@direct.healthsystem.virginia.edu

Organizations & group practices 11

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": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1154398642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229069007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 LEE ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080817",
            "telephone_number": "434-924-9333",
            "fax_number": "434-243-3938"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229080816",
            "country_code": "US",
            "telephone_number": "434-924-9400",
            "fax_number": "434-982-1618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOSTAKOGLU SHIELDS",
        "first_name": "LALE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-02",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "VA",
            "license": "0101267678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lkostakoglushields446466@direct.healthsystem.virginia.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1240 Lee St",
            "city": "Charlottesville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "229080817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LALE",
            "last_name": "KOSTAKOGLU",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.