NPIMap

Organization Active NPI

Susquehanna Imaging Associates, Inc.

  • Diagnostic Radiology Physician
  • Williamsport, PA
National Provider Identifier
1326069212
Registry record updated Nov 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
SUSQUEHANNA IMAGING ASSOCIATES, INC.
Practice address
700 High St
Williamsport, PA 17701-3100
Phone
(570) 322-1161
Fax
(570) 322-2030
NPI assigned
Jul 23, 2006
Last updated
Nov 1, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2012

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

Authorized official

Name
Shabbir Abbas Esaa, M.D.NPI 1295740082
Title
President
Phone
(570) 322-1161

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

700 High St
Williamsport, PA 17701-3100

Mailing address

700 High St
Williamsport, PA 17701-3100
Phone (570) 322-1161

Other identifiers 1

IdentifierTypeStateIssuer
0014946760021MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, FL, NY, NJ4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20040312000168 PA Part B Supplier - Clinic/Group Practice 3870482409 Receives reassigned benefits from 8 practitioners
Practice locations: Montoursville, PA; Williamsport, PA; Muncy, PA; Lock Haven, PA
O20131024000789 FL Part B Supplier - Clinic/Group Practice 3870482409 Receives reassigned benefits from 2 practitioners
Practice locations: Winter Garden, FL
O20250314002695 NY Part B Supplier - Clinic/Group Practice 3870482409 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY
O20250703003971 NJ Part B Supplier - Clinic/Group Practice 3870482409 Receives reassigned benefits from 1 practitioner
Practice locations: Cape May Court House, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351728000000",
    "number": "1326069212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 HIGH ST",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177013100",
            "telephone_number": "570-322-1161",
            "fax_number": "570-322-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 HIGH ST",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177013100",
            "telephone_number": "570-322-1161",
            "fax_number": "570-322-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSQUEHANNA IMAGING ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2012-11-01",
        "status": "A",
        "authorized_official_last_name": "ESAA",
        "authorized_official_first_name": "SHABBIR",
        "authorized_official_middle_name": "ABBAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-322-1161",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014946760021",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsport, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2012; 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.