Prospect Hill Radiology Group P C
Organization Active NPI Diagnostic Radiology Physician · Syracuse, NY
NPI 1235122425 · NPPES record last updated Apr 9, 2026
Key facts
- NPI
- 1235122425
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- 108725 (NY)
- Legal business name
- PROSPECT HILL RADIOLOGY GROUP P C
- Practice address
- 301 Prospect Ave
Syracuse, NY 13203-1807 - Phone
- (315) 448-5274
- NPI assigned
- Aug 24, 2005
- Organization subpart
- No
Authorized official
- Name
- Dr. Alan Foster, M.D.
- Title
- Medical Director
- Phone
- (315) 703-5119
Member organizations 1
Practitioners 61
-
Lawrence Calabrese, M.D.
-
John P Teixeira, M.D.
-
Shain S Wallis, DO
-
Mark T. Baesl, MD
-
Michael Chang, M.D.
-
Philip J. Fraccola, M.D.
-
Gary D Leavitt, M.D.
-
Juno Lee, M.D.
-
Srinivas R Paidy, M.D.
-
Sherwin C Pollock, M.D.
-
Stacey Margaret Schneble, NP-C
-
James M Terzian, M.D.
-
Nicholas C Trasolini, M.D.
-
Carl P Guarino, MD
-
Dean V Moesch, M.D.
-
Chris Donikyan, DO
-
Lisa Ann Fisher, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (5 enrollments) in NY, NJ, RI, GA, CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040729001373 | NY | Part B Supplier - Clinic/Group Practice | 6204806862 |
Receives reassigned benefits from 44 practitioners Practice locations: Syracuse, NY |
| O20190312000380 | NJ | Part B Supplier - Clinic/Group Practice | 6204806862 |
Receives reassigned benefits from 3 practitioners Practice locations: Allendale, NJ; Towaco, NJ; Upper Saddle River, NJ |
| O20190327000709 | RI | Part B Supplier - Clinic/Group Practice | 6204806862 |
Receives reassigned benefits from 1 practitioner Practice locations: Coventry, RI |
| O20190403002331 | GA | Part B Supplier - Clinic/Group Practice | 6204806862 |
Receives reassigned benefits from 1 practitioner Practice locations: Rome, GA; Tybee Island, GA |
| O20260410000613 | CA | Part B Supplier - Clinic/Group Practice | 6204806862 |
Receives reassigned benefits from 1 practitioner Practice locations: Westlake Village, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | 108725 | NY | Yes |
Addresses
Primary practice location
301 Prospect Ave
Syracuse, NY 13203-1807
Mailing address
4567 Crossroads Park Dr FL 2
Liverpool, NY 13088-3589
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All providers in Syracuse, NY · Diagnostic Radiology Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 9, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.