NPIMap

Organization Active NPI

Radiologic Associates PC

  • Diagnostic Radiology Physician
  • Bristol, CT
National Provider Identifier
1386704229
Registry record updated Oct 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
RADIOLOGIC ASSOCIATES PC
Practice address
25 Collins Road
Bristol, CT 06010
Phone
(860) 584-0541
Fax
(860) 584-9998
NPI assigned
Dec 11, 2006
Last updated
Oct 28, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2016

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

Authorized official

Name
Christopher J Leary, MDNPI 1710997481
Title
President
Phone
(860) 584-1320

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 Physician 2085R0202X Primary

Addresses

Primary practice location

25 Collins Road
Bristol, CT 06010

Mailing address

985 Farmington Ave
PO Box 277
Bristol, CT 06010-3973
Phone (860) 584-1320

Other identifiers 1

IdentifierTypeStateIssuer
004000345MedicaidCT

Other names 1

  • Bristol Radiology Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040203000872 CT Part B Supplier - Clinic/Group Practice 6901799097 Receives reassigned benefits from 7 practitioners
Practice locations: Bristol, CT

National Provider Directory

National Provider Directory

Locations

985 Farmington Ave
Bristol, CT 06010
Phone (860) 584-1320

353 Scott Swamp Rd
#D
Farmington, CT 06032
Phone (860) 677-7682

Practitioners & affiliated clinicians

Practitioners 8

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": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477612800000",
    "number": "1386704229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "985 FARMINGTON AVE",
            "address_2": "PO BOX 277",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060103973",
            "telephone_number": "860-584-1320",
            "fax_number": "860-584-2152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 COLLINS ROAD",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "06010",
            "telephone_number": "860-584-0541",
            "fax_number": "860-584-9998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIOLOGIC ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2016-10-28",
        "status": "A",
        "authorized_official_last_name": "LEARY",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-584-1320",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004000345",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bristol Radiology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bristol, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2016; 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.