NPIMap

Organization Active NPI

Southtowns Radiology Associates, LLC

  • Diagnostic Radiology Physician
  • Hamburg, NY
National Provider Identifier
1295779072
Registry record updated Dec 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
SOUTHTOWNS RADIOLOGY ASSOCIATES, LLC
Practice address
3040 Amsdell Rd
Hamburg, NY 14075-5835
Phone
(716) 649-9000
Fax
(716) 649-9005
NPI assigned
Jun 15, 2006
Last updated
Dec 9, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2014

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

Authorized official

Name
Edith R Haier
Title
Delegated Offical
Phone
(716) 649-9000

Specialties & licenses 1

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

Addresses

Primary practice location

3040 Amsdell Rd
Hamburg, NY 14075-5835

Mailing address

3040 Amsdell Rd
Hamburg, NY 14075-5835
Phone (716) 649-9000

Other names 1

  • Southtowns Radiology Associates, LLC. Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL, VA, IL, PA, TX, DC, NJ, WI, NC10 enrollments

Enrollment records 10

Enrollment IDStateProvider typePAC IDDetails
O20031219000381 NY Part B Supplier - Clinic/Group Practice 9830097542 Receives reassigned benefits from 50 practitioners
3 other NPIs on this enrollment
Practice locations: Albertson, NY; West Seneca, NY; Rochester, NY; Poughkeepsie, NY; Plattsburgh, NY; Orchard Park, NY; Old Westbury, NY; Newburgh, NY…
O20190906003042 FL Part B Supplier - Clinic/Group Practice 9830097542 Receives reassigned benefits from 1 practitioner
Practice locations: Jacksonville, FL; Stuart, FL; Tampa, FL
O20240503000641 VA Part B Supplier - Clinic/Group Practice 9830097542 Receives reassigned benefits from 1 practitioner
Practice locations: Bristol, VA
O20240708001358 IL Part B Supplier - Clinic/Group Practice 9830097542 Receives reassigned benefits from 4 practitioners
Practice locations: Lisle, IL; Naperville, IL; Oak Brook, IL
O20240815000030 PA Part B Supplier - Clinic/Group Practice 9830097542 Receives reassigned benefits from 1 practitioner
Practice locations: Pittsburgh, PA
O20240827004632 TX Part B Supplier - Clinic/Group Practice 9830097542 Receives reassigned benefits from 2 practitioners
Practice locations: Sugar Land, TX
O20240909000056 DC Part B Supplier - Clinic/Group Practice 9830097542 Receives reassigned benefits from 4 practitioners
Practice locations: Silver Spring, MD; Washington, DC
O20241014004165 NJ Part B Supplier - Clinic/Group Practice 9830097542 Receives reassigned benefits from 1 practitioner
Practice locations: Princeton, NJ
O20250217001273 WI Part B Supplier - Clinic/Group Practice 9830097542 Receives reassigned benefits from 1 practitioner
Practice locations: Madison, WI
O20251106000032 NC Part B Supplier - Clinic/Group Practice 9830097542 Receives reassigned benefits from 2 practitioners
Practice locations: Raleigh, NC; Waxhaw, NC

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory

Locations

12653 Seneca Rd
Irving, NY 14081
Phone (716) 934-9001

Practitioners & affiliated clinicians

Practitioners 80

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 80

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418083200000",
    "number": "1295779072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 AMSDELL RD",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140755835",
            "telephone_number": "716-649-9000",
            "fax_number": "716-649-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 AMSDELL RD",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140755835",
            "telephone_number": "716-649-9000",
            "fax_number": "716-649-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHTOWNS RADIOLOGY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2014-12-09",
        "status": "A",
        "authorized_official_last_name": "HAIER",
        "authorized_official_first_name": "EDITH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DELEGATED OFFICAL",
        "authorized_official_telephone_number": "716-649-9000"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southtowns Radiology Associates, LLC.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hamburg, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2014; 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.