NPIMap

Organization Active NPI

SLR Diagnostic Radiology, P.C.

Doing business as St. Luke's-Roosevelt Hospital Center, Dept of Radiology

  • Radiological Physics Physician
  • New York, NY
National Provider Identifier
1225069149
Registry record updated Feb 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiological Physics PhysicianTaxonomy code 2085R0205X
Legal business name
SLR DIAGNOSTIC RADIOLOGY, P.C.
Doing business as
St. Luke's-Roosevelt Hospital Center, Dept of Radiology
Practice address
1111 Amsterdam Ave
Dept of Radiology
New York, NY 10025-1716
Phone
(201) 830-3122
Fax
(201) 200-0838
NPI assigned
Jul 6, 2006
Last updated
Feb 11, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
SLR DIAGNOSTIC RADIOLOGY, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 11, 2013

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

Authorized official

Name
Jeanne Baer, MD
Title
President
Phone
(201) 830-3122

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Radiology Physician 2085N0904X NU
Pediatric Radiology Physician 2085P0229X NU
Diagnostic Radiology Physician 2085R0202X NU
Radiological Physics Physician 2085R0205X NU Primary

Addresses

Primary practice location

1111 Amsterdam Ave
Dept of Radiology
New York, NY 10025-1716

Mailing address

PO Box 10269
Uniondale, NY 11555-0269
Phone (201) 830-3122

Other identifiers 1

IdentifierTypeStateIssuer
01002042MedicaidNY

Other names 1

  • St. Luke's-Roosevelt Hospital Center, Dept of Radiology Doing business as

National Provider Directory

National Provider Directory
Part of
SLR Diag Rad PC

Practitioners & affiliated clinicians

Practitioners 124

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 124

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360540800000",
    "number": "1225069149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10269",
            "city": "UNIONDALE",
            "state": "NY",
            "postal_code": "115550269",
            "telephone_number": "201-830-3122",
            "fax_number": "201-200-0838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 AMSTERDAM AVE",
            "address_2": "DEPT OF RADIOLOGY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251716",
            "telephone_number": "201-830-3122",
            "fax_number": "201-200-0838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLR DIAGNOSTIC RADIOLOGY, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SLR DIAGNOSTIC RADIOLOGY, P.C.",
        "enumeration_date": "2006-07-06",
        "last_updated": "2013-02-11",
        "status": "A",
        "authorized_official_last_name": "BAER",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-830-3122",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0205X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiological Physics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01002042",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Luke's-Roosevelt Hospital Center, Dept of Radiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 11, 2013; 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.