NPIMap

Organization Active NPI

Northstar Radiology

  • Diagnostic Radiology Physician
  • Winnemucca, NV
National Provider Identifier
1356768014
Registry record updated Aug 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 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
Last updated
Aug 27, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2015

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

Authorized official

Name
Dr. Robert G Leckie, M.D.NPI 1861490559
Title
Partner
Phone
(608) 788-8103

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 PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0202X Primary

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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": "1395187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440633600000",
    "number": "1356768014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2031 32ND ST S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546017099",
            "telephone_number": "608-788-8103",
            "fax_number": "608-788-8799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 E HASKELL ST",
            "city": "WINNEMUCCA",
            "state": "NV",
            "postal_code": "894453247",
            "telephone_number": "608-788-8103",
            "fax_number": "608-788-8799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSTAR RADIOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-19",
        "last_updated": "2015-08-27",
        "status": "A",
        "authorized_official_last_name": "LECKIE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "608-788-8103",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winnemucca, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.