NPIMap

Organization Active NPI

Stony Brook Radiologic Services PC

  • Diagnostic Radiology Physician
  • Stony Brook, NY
National Provider Identifier
1295780112
Registry record updated Nov 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
STONY BROOK RADIOLOGIC SERVICES PC
Practice address
2500 Nesconset Hwy
Suite 15a
Stony Brook, NY 11790-2555
Phone
(631) 751-2900
Fax
(631) 751-2051
NPI assigned
May 23, 2006
Last updated
Nov 2, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2007

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

Authorized official

Name
Mr. John Colbert
Title
Cfo
Phone
(631) 231-0300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

2500 Nesconset Hwy
Suite 15a
Stony Brook, NY 11790-2555

Mailing address

2500 Nesconset Hwy
Suite 15a
Stony Brook, NY 11790-2555
Phone (631) 751-2900

Other identifiers 1

IdentifierTypeStateIssuer
02284260MedicaidNY

National Provider Directory

National Provider Directory

Locations

2500 Nesconset Hwy
Bldg 15A
Stony Brook, NY 11790
Phone (631) 751-2900

Practitioners & affiliated clinicians

Practitioners 45

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 45

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193961600000",
    "number": "1295780112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NESCONSET HWY",
            "address_2": "SUITE 15A",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902555",
            "telephone_number": "631-751-2900",
            "fax_number": "631-751-2051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NESCONSET HWY",
            "address_2": "SUITE 15A",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902555",
            "telephone_number": "631-751-2900",
            "fax_number": "631-751-2051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONY BROOK RADIOLOGIC SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2007-11-02",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "631-231-0300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02284260",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2007; 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.