Ian Ralph Whiteside, M.D.

Primary specialty

Body Imaging PhysicianTaxonomy code 2085B0100X

License

303407 Issued in NY

Practice address

200 Belle Terre Rd
Port Jefferson, NY 11777-1968

Phone

(631) 474-6000

NPI assigned

May 13, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Diagnostic Radiology

Education

Eastern Virginia Medical School, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Empire State Radiology P CGroup PAC ID 4385075241, 266 clinicians

St Francis Cardiac Prevention Services PCGroup PAC ID 4183515836, 60 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Samaritan Hospital Medical Center Hospital, West Islip, NY, CCN 330286
• St Catherine of Siena Hospital Hospital, Smithtown, NY, CCN 330401
• St Charles Hospital Hospital, Port Jefferson, NY, CCN 330246
• St Francis Hospital - the Heart Center Hospital, Roslyn, NY, CCN 330182
• Chsli St Joseph Hospital Hospital, Bethpage, NY, CCN 330332

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359

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.

• Empire State Radiology P C

  • Diagnostic Radiology Physician
  • West Islip, NY
  • NPI 1255962783
  Medicare reassignment Care Compare group NPD
• St. Francis Cardiac Prevention Services PC

  • Diagnostic Radiology Physician
  • Melville, NY
  • NPI 1376952804
  Medicare reassignment Care Compare group NPD
• CHS Physician Partners, PC

  • Interventional Cardiology Physician
  • Fresh Meadows, NY
  • NPI 1407089345
  Medicare reassignment NPD
• CHS Physician Partners, P.C

  • Cardiovascular Disease Physician
  • Roslyn, NY
  • NPI 1164585725
  NPD
• CHS Physician Partners, PC

  • Cardiovascular Disease Physician
  • Massapequa, NY
  • NPI 1992048342
  NPD

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

• Good Samaritan Hospital Medical Center

  • General Acute Care Hospital
  • West Islip, NY
  • NPI 1902865355
  Care Compare affiliation
• St Charles Hospital Corp

  • General Acute Care Hospital
  • Port Jefferson, NY
  • NPI 1164481529
  Care Compare affiliation
• St. Catherine of Siena Medical Center

  • General Acute Care Hospital
  • Smithtown, NY
  • NPI 1982663423
  Care Compare affiliation
• St. Francis Hospital

  • General Acute Care Hospital
  • Roslyn, NY
  • NPI 1043279565
  Care Compare affiliation
• Wsnchs North, Inc.

  • General Acute Care Hospital
  • Bethpage, NY
  • NPI 1013998426
  Care Compare affiliation

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

{
    "created_epoch": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627084800000",
    "number": "1437560430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 UTAH AVE STE 200",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902454817",
            "telephone_number": "424-290-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BELLE TERRE RD",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771968",
            "telephone_number": "631-474-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITESIDE",
        "first_name": "IAN",
        "middle_name": "RALPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-13",
        "last_updated": "2021-07-24",
        "certification_date": "2021-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "NY",
            "license": "303407",
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "NY",
            "license": "303407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jillian Susanne Weiss, DO
• Lois L Weiss, DDS
• Carolyn Werr
• Sung Whang, MD
• Nicole White
• Barbara J Wickenhauser
• Michelle K Wiley
• Robert G Williams, DDS
• Paul Dana Willms, FNP-C
• Lisa Nicole Wilson, NP

• Body Imaging Physician in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Body Imaging Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.