Northstar Radiology
Organization Active NPI Diagnostic Radiology Physician · Winnemucca, NV
NPI 1356768014 · NPPES record last updated Aug 27, 2015
Key facts
- NPI
- 1356768014
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- Legal business name
- NORTHSTAR RADIOLOGY
- Practice address
- 118 E Haskell St
Winnemucca, NV 89445-3247 - Phone
- (608) 788-8103
- Fax
- (608) 788-8799
- NPI assigned
- Mar 19, 2014
- Organization subpart
- No
Authorized official
- Name
- Dr. Robert G Leckie, M.D.
- Title
- Partner
- Phone
- (608) 788-8103
Practitioners 11
-
Sandra Jill Althaus, M.D.
-
Hubert Chin, MD
-
John L Griffith, M.D.
-
Leon S Jackson, MD
-
Brian Evans, M.D.
-
Jeffrey Steven Fountain, D.O.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NV
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150319002350 | NV | Part B Supplier - Clinic/Group Practice | 7517284151 |
Receives reassigned benefits from 11 practitioners Practice locations: Ely, NV; Winnemucca, NV; Sparks, NV; Lovelock, NV |
National Provider Directory
Locations
500 1st Ave
Portola, CA 96122
Phone (530) 832-4277
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | Yes |
Addresses
Primary practice location
118 E Haskell St
Winnemucca, NV 89445-3247
Mailing address
2031 32ND St S
La Crosse, WI 54601-7099
Phone (608) 788-8103
Other providers in Winnemucca, NV
- Northern Nevada Eyecare LTD
- Northern Nevada Eyecare LTD
- Northern Nevada Human Services
- Northern Nevada Human Services
- Northstar Imaging Inc
- Tammy Lea Palm
- Karen Palmer
- Alexandra Paredes
- Megan Parry
- Anthony Pasquale
All providers in Winnemucca, NV · Diagnostic Radiology Physician in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 27, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.