NPIMap

Organization Active NPI

Northeast Radiology PC

  • Diagnostic Radiology Physician
  • Mount Kisco, NY
National Provider Identifier
1255320727
Registry record updated Oct 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
NORTHEAST RADIOLOGY PC
Practice address
666 Lexington Ave
Mount Kisco, NY 10549
Phone
(914) 666-6692
Fax
(914) 666-0637
NPI assigned
Oct 18, 2005
Last updated
Oct 30, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2018

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

Authorized official

Name
Howard Lee, MDNPI 1396728796
Title
President
Phone
(845) 278-6200

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

666 Lexington Ave
Mount Kisco, NY 10549

Mailing address

3839 Danbury Rd
Brewster, NY 10509
Phone (845) 278-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, VT, NJ, GA, FL, AL, IL, OH8 enrollments

Enrollment records 8

Enrollment IDStateProvider typePAC IDDetails
O20040320000188 NY Part B Supplier - Clinic/Group Practice 7315838448 Receives reassigned benefits from 7 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mount Kisco, NY; Syosset, NY; Kings Point, NY; East Amherst, NY; Brewster, NY
O20250620001943 VT Part B Supplier - Clinic/Group Practice 7315838448 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Alburgh, VT
O20250715000640 NJ Part B Supplier - Clinic/Group Practice 7315838448 Receives reassigned benefits from 3 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Edison, NJ; Summit, NJ; Freehold, NJ
O20250723003923 GA Part B Supplier - Clinic/Group Practice 7315838448 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kennesaw, GA
O20250725000270 FL Part B Supplier - Clinic/Group Practice 7315838448 Receives reassigned benefits from 5 practitioners
4 other NPIs on this enrollment
Practice locations: Jacksonville, FL; Naples, FL; Palm City, FL; Panama City, FL
O20250801002371 AL Part B Supplier - Clinic/Group Practice 7315838448 Receives reassigned benefits from 2 practitioners
3 other NPIs on this enrollment
Practice locations: Dothan, AL; Montgomery, AL
O20250807002435 IL Part B Supplier - Clinic/Group Practice 7315838448 Receives reassigned benefits from 2 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: South Barrington, IL; Wilmette, IL
O20260609000359 OH Part B Supplier - Clinic/Group Practice 7315838448 Receives reassigned benefits from 1 practitioner
Practice locations: Dublin, OH

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
Northeast Radiology of Connecticut LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3630 S0 HL Blvd
Jefferson Vly, NY 10535
Phone (914) 245-8181

Practitioners & affiliated clinicians

Practitioners 33

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 33

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540857600000",
    "number": "1255320727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3839 DANBURY RD",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "10509",
            "telephone_number": "845-278-6200",
            "fax_number": "845-278-7802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "666 LEXINGTON AVE",
            "city": "MOUNT KISCO",
            "state": "NY",
            "postal_code": "10549",
            "telephone_number": "914-666-6692",
            "fax_number": "914-666-0637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST RADIOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-18",
        "last_updated": "2018-10-30",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "845-278-6200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Kisco, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; 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.