Organization Active NPI

Memorial Nuclear Medicine Group

  • Nuclear Medicine Physician
  • New York, NY
National Provider Identifier
1194702282
Registry record updated Apr 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Medicine PhysicianTaxonomy code 207U00000X
Legal business name
MEMORIAL NUCLEAR MEDICINE GROUP
Practice address
1275 York Ave
New York, NY 10021-6007
Phone
(212) 639-2000
NPI assigned
Dec 29, 2005
Last updated
Apr 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2008

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

Authorized official

Name
Salvatore M Andreozzi
Title
Associate Director
Phone
(646) 227-3751

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207U00000X Primary

Addresses

Primary practice location

1275 York Ave
New York, NY 10021-6007

Mailing address

633 3Rd Ave
Box 3
New York, NY 10017-6706

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, ND, NJ, CA, CT, PR, FL, MA, NV9 enrollments

Enrollment records 9

Enrollment IDStateProvider typePAC IDDetails
O20040313000313 NY Part B Supplier - Clinic/Group Practice 9638068067 Receives reassigned benefits from 58 practitioners
Practice locations: New York, NY; Uniondale, NY; West Harrison, NY
O20230127002103 ND Part B Supplier - Clinic/Group Practice 9638068067 Receives reassigned benefits from 1 practitioner
Practice locations: Fargo, ND
O20240507003345 NJ Part B Supplier - Clinic/Group Practice 9638068067 Receives reassigned benefits from 1 practitioner
Practice locations: Montvale, NJ; Middletown, NJ; Basking Ridge, NJ
O20240924002021 CA Part B Supplier - Clinic/Group Practice 9638068067 Receives reassigned benefits from 1 practitioner
Practice locations: San Clemente, CA
O20241111002028 CT Part B Supplier - Clinic/Group Practice 9638068067 Receives reassigned benefits from 1 practitioner
Practice locations: Cheshire, CT
O20250910000372 PR Part B Supplier - Clinic/Group Practice 9638068067 Receives reassigned benefits from 1 practitioner
Practice locations: San Juan, PR
O20250919000055 FL Part B Supplier - Clinic/Group Practice 9638068067 Receives reassigned benefits from 3 practitioners
Practice locations: Hialeah, FL; Miami, FL; Weston, FL
O20260316000419 MA Part B Supplier - Clinic/Group Practice 9638068067 Receives reassigned benefits from 1 practitioner
Practice locations: Dedham, MA
O20260317002124 NV Part B Supplier - Clinic/Group Practice 9638068067 Receives reassigned benefits from 1 practitioner
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

225 Summit Ave
Montvale, NJ 07645
Phone (908) 542-3336

633 Third Ave
New York, NY 10117

500 Westchester Ave
West Harrison, NY 10604
Phone (914) 367-7000

Practitioners & affiliated clinicians

Practitioners 63

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 63

NPI Registry JSON

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208044800000",
    "number": "1194702282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 3RD AVE",
            "address_2": "BOX 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100216007",
            "telephone_number": "212-639-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL NUCLEAR MEDICINE GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-29",
        "last_updated": "2008-04-13",
        "status": "A",
        "authorized_official_last_name": "ANDREOZZI",
        "authorized_official_first_name": "SALVATORE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ASSOCIATE DIRECTOR",
        "authorized_official_telephone_number": "646-227-3751"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 13, 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.