NPIMap

Organization Active NPI

Innovative Mr Imaging, PC

  • Diagnostic Radiology Physician
  • New York, NY
National Provider Identifier
1265635015
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
INNOVATIVE MR IMAGING, PC
Practice address
5000 Broadway
New York, NY 10034-1602
Phone
(718) 815-2002
Fax
(718) 815-3003
NPI assigned
Jun 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Brian Goldberg
Title
Administrator
Phone
(516) 369-8272

Specialties & licenses 1

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

Addresses

Primary practice location

5000 Broadway
New York, NY 10034-1602

Mailing address

PO Box 30271
Staten Island, NY 10303-0271
Phone (718) 815-2002

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1181260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265635015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30271",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103030271",
            "telephone_number": "718-815-2002",
            "fax_number": "718-815-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100341602",
            "telephone_number": "718-815-2002",
            "fax_number": "718-815-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE MR IMAGING, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOLDBERG",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "516-369-8272"
    },
    "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 New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.