Organization Active NPI

Nassau-Suffolk Radiological Associates, P.C.

  • Specialist
  • Lindenhurst, NY
National Provider Identifier
1295940435
Registry record updated May 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
114256 Issued in NY
Legal business name
NASSAU-SUFFOLK RADIOLOGICAL ASSOCIATES, P.C.
Practice address
20 West John Street
Lindenhurst, NY 11757
Phone
(631) 226-2230
Fax
(631) 226-3024
NPI assigned
May 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2019

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

Authorized official

Name
Mr. Roberto Antonacci, MD
Title
Owner/President
Phone
(917) 968-4916

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 114256 NY Primary

Addresses

Primary practice location

20 West John Street
Lindenhurst, NY 11757

Mailing address

2780 Middle Country Road
Suite 210
Lake Grove, NY 11755
Phone (631) 588-4500

Other identifiers 1

IdentifierTypeStateIssuer
00387302MedicaidNY

Other names 1

  • LINDENHURST XRAY CENTER Other name

National Provider Directory

National Provider Directory

Locations

20 W John St
Lindenhurst, NY 11757
Phone (516) 241-4242

4600 Sunrise Hwy
Massapequa Pk, NY 11762
Phone (516) 541-4242

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558483200000",
    "number": "1295940435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 MIDDLE COUNTRY ROAD",
            "address_2": "SUITE 210",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "11755",
            "telephone_number": "631-588-4500",
            "fax_number": "631-588-4595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 WEST JOHN STREET",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "11757",
            "telephone_number": "631-226-2230",
            "fax_number": "631-226-3024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NASSAU-SUFFOLK RADIOLOGICAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2019-05-22",
        "status": "A",
        "authorized_official_last_name": "ANTONACCI",
        "authorized_official_first_name": "ROBERTO",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "917-968-4916",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "114256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00387302",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LINDENHURST XRAY CENTER",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "LINDENHURST XRAY CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lindenhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; 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.