Individual provider Active NPI

Daku Siewe, MD

  • Diagnostic Radiology Physician
  • Buffalo, NY
National Provider Identifier
1346668191
Registry record updated Sep 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
82868 Issued in GA
Practice address
2157 Main St
Buffalo, NY 14214-2648
Phone
(716) 828-2982
NPI assigned
Mar 30, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X 82868 GA
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X 82868 GA Primary

Addresses

Primary practice location

2157 Main St
Buffalo, NY 14214-2648

Mailing address

1327 Briar Creek Rd
Apt 7
Charlotte, NC 28205-6275
Phone (918) 633-9208

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190727000090 GA Practitioner - Diagnostic Radiology 7416256847 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of North Carolina at Chapel Hill School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates of North GeorgiaGroup PAC ID 2769715044, 36 clinicians
Athens Radiology Associates PCGroup PAC ID 2860486107, 34 clinicians

Practice addresses (Care Compare)

1199 Prince Ave
Athens, GA 30606-2797
Phone (706) 475-7000

1230 Baxter St
Athens, GA 30606-3712
Phone (706) 548-7581

Hospital & facility affiliations

  • Piedmont Athens Regional Medical Center Hospital, Athens, GA, CCN 110074
  • St Mary'S Hospital Hospital, Athens, GA, CCN 110006
  • St Marys Good Samaritan Hospital Hospital, Greensboro, GA, CCN 111329
  • Piedmont Walton Hospital Hospital, Monroe, GA, CCN 110046
  • Ty Cobb Regional Medical Center, LLC Hospital, Lavonia, GA, CCN 110027

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
82868GAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Radiology, LLC CurrentSince May 1, 2022 Accepting new patients
Emory Medical Care Foundation Inc Current Accepting new patients
M & B Imaging, PC Diagnostic Radiology CurrentSince Jan 22, 2022 Accepting new patients
Emory Medical Care Foundation Inc Body Imaging CurrentSince Jul 1, 2019 Accepting new patients
Synergy Radiology, LLC Diagnostic Radiology CurrentSince May 1, 2022 Accepting new patients
American Health Imaging of Georgia LLC CurrentSince May 1, 2022 Accepting new patients
American Health Imaging of Georgia, LLC CurrentSince Dec 31, 2021 Accepting new patients
Radiology Associates of North Georgia Diagnostic Radiology CurrentSince Jul 1, 2020 Accepting new patients
The Emory Clinic Inc Diagnostic Radiology CurrentSince Jul 1, 2019 Accepting new patients
Athens Radiology Associates PC Diagnostic Radiology CurrentSince Jul 1, 2020 Accepting new patients
Pro Radiology, LLC PastSince May 1, 2022 Accepting new patients

Locations

3320 Old Jefferson Rd
Ste 200
Athens, GA 30607
Phone (706) 549-5560

1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520

1230 Baxter St
Athens, GA 30606
Phone (706) 364-3100

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

1501 Milstead Rd NE
Ste 140
Conyers, GA 30012

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

9459 Highway 5
Ste R
Douglasville, GA 30135

6025 Professional Pkwy
Ste 104
Douglasville, GA 30134
Phone (770) 444-9981

367 Clear Creek Pkwy
Lavonia, GA 30553
Phone (706) 356-7800

2151 W Spring St
Monroe, GA 30655
Phone (770) 267-1792

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1396137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1346668191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1327 BRIAR CREEK RD",
            "address_2": "APT 7",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282056275",
            "telephone_number": "918-633-9208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2157 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142142648",
            "telephone_number": "716-828-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEWE",
        "first_name": "DAKU",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-30",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "GA",
            "license": "82868",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "82868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.