NPIMap

Organization Active NPI

Stand-Up MRI of Carle Place, P.C.

  • Diagnostic Radiology Physician
  • Carle Place, NY
National Provider Identifier
1295826584
Registry record updated Apr 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
STAND-UP MRI OF CARLE PLACE, P.C.
Practice address
31 Old Country Rd
Carle Place, NY 11514-1800
Phone
(516) 746-2248
Fax
(516) 746-2218
NPI assigned
Sep 28, 2006
Last updated
Apr 22, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2015

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

Authorized official

Name
Stephen M. Hershowitz, M.D.NPI 1619970084
Title
Owner
Phone
(631) 694-2816

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 Physician 2085R0202X NU Primary

Addresses

Primary practice location

31 Old Country Rd
Carle Place, NY 11514-1800

Mailing address

PO Box 170
Farmingdale, NY 11735-0170
Phone (631) 694-2816

Other identifiers 1

IdentifierTypeStateIssuer
02865130MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040218000658 NY Part B Supplier - Clinic/Group Practice 3971498940 Receives reassigned benefits from 19 practitioners
Practice locations: Carle Place, NY

National Provider Directory

National Provider Directory

Locations

31 Old Country Rd
Carle Place, NY 11514
Phone (516) 746-2248

Practitioners & affiliated clinicians

Practitioners 22

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 22

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429660800000",
    "number": "1295826584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 170",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117350170",
            "telephone_number": "631-694-2816",
            "fax_number": "631-396-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 OLD COUNTRY RD",
            "city": "CARLE PLACE",
            "state": "NY",
            "postal_code": "115141800",
            "telephone_number": "516-746-2248",
            "fax_number": "516-746-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAND-UP MRI OF CARLE PLACE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2015-04-22",
        "status": "A",
        "authorized_official_last_name": "HERSHOWITZ",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-694-2816",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02865130",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carle Place, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; 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.