NPIMap

Organization Active NPI

Stand-Up MRI of Manhattan, P.C.

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • New York, NY
National Provider Identifier
1194956268
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
Legal business name
STAND-UP MRI OF MANHATTAN, P.C.
Practice address
191 Avenue a
New York, NY 10009-4094
Phone
(212) 674-8300
Fax
(212) 674-8828
NPI assigned
Aug 6, 2009
Last updated
Jul 7, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Authorized official

Name
Ronald S Wagner, M.D.NPI 1689661415
Title
Owner
Phone
(631) 694-2816

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X Primary
Diagnostic Radiology Physician 2085R0202X

Addresses

Primary practice location

191 Avenue a
New York, NY 10009-4094

Mailing address

110 Marcus Drive
Melville, NY 11747-4228
Phone (631) 390-1667

Other practice location 1

305 (Suite 102) E. 55th Street
New York, NY 10022-4148
Phone (212) 772-2300

Other practice location 2

301 E 55th St
New York, NY 10022-4101
Phone (212) 772-2300

Other identifiers 1

IdentifierTypeStateIssuer
03175380MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040427000389 NY Part B Supplier - Clinic/Group Practice 7618964206 Receives reassigned benefits from 17 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New York, NY

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

301 E 55th St
New York, NY 10022
Phone (212) 772-2300

Practitioners & affiliated clinicians

Practitioners 19

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 19

NPI Registry JSON

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

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657152000000",
    "number": "1194956268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 MARCUS DRIVE",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474228",
            "telephone_number": "631-390-1667",
            "fax_number": "631-390-1780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 AVENUE A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100094094",
            "telephone_number": "212-674-8300",
            "fax_number": "212-674-8828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 (Suite 102) E. 55th Street",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100224148",
            "country_code": "US",
            "telephone_number": "212-772-2300",
            "fax_number": "212-772-2032",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 E 55th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100224101",
            "country_code": "US",
            "telephone_number": "212-772-2300",
            "fax_number": "212-772-2032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "STAND-UP MRI OF MANHATTAN, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-06",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-694-2816",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03175380",
            "state": "NY"
        }
    ],
    "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 Jul 7, 2022; 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.