Individual provider Active NPI

Soodabeh Haeri, MD

  • Diagnostic Radiology Physician
  • Brooklyn, NY
National Provider Identifier
1245268101
Registry record updated Jan 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
1292861 Issued in NY
Practice address
345 Schermerhorn St
Downtown Center
Brooklyn, NY 11217-1025
Phone
(718) 403-3599
Fax
(718) 403-3591
NPI assigned
Jun 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 1292861 NY Primary

Addresses

Primary practice location

345 Schermerhorn St
Downtown Center
Brooklyn, NY 11217-1025

Mailing address

233 Nostrand Ave
Brooklyn, NY 11205-4924
Phone (718) 826-5911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1292861NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Brooklyn Medical Group PC Past Accepting new patients

Organizations & group practices 1

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233273600000",
    "number": "1245268101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 NOSTRAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112054924",
            "telephone_number": "718-826-5911",
            "fax_number": "718-826-5860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 SCHERMERHORN ST",
            "address_2": "DOWNTOWN CENTER",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112171025",
            "telephone_number": "718-403-3599",
            "fax_number": "718-403-3591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAERI",
        "first_name": "SOODABEH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2009-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "1292861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2009; 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.