Organization Active NPI

Bayonne Imaging Associates, LLC.

  • Diagnostic Radiology Physician
  • Bayonne, NJ
National Provider Identifier
1417951880
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
25MA06884700 Issued in NJ
Legal business name
BAYONNE IMAGING ASSOCIATES, LLC.
Practice address
29TH Street at Avenue E
Bayonne, NJ 07002
Phone
(201) 858-5461
Fax
(201) 243-4229
NPI assigned
Jun 13, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Peter L Smith, M.D.
Title
Director/Owner/Active Radiologist
Phone
(201) 858-5461

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 25MA06884700 NJ Primary

Addresses

Primary practice location

29TH Street at Avenue E
Bayonne, NJ 07002

Mailing address

29TH Street at Avenue E
Bayonne, NJ 07002
Phone (201) 858-5461

Other identifiers 1

IdentifierTypeStateIssuer
0004502MedicaidNJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1118620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417951880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29TH STREET AT AVENUE E",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "07002",
            "telephone_number": "201-858-5461",
            "fax_number": "201-243-4229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29TH STREET AT AVENUE E",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "07002",
            "telephone_number": "201-858-5461",
            "fax_number": "201-243-4229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYONNE IMAGING ASSOCIATES, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR/OWNER/ACTIVE RADIOLOGIST",
        "authorized_official_telephone_number": "201-858-5461",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA06884700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0004502",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.