Individual provider Active NPI

Michele Licht

  • Diagnostic Radiology Physician
  • New York, NY
National Provider Identifier
1457390171
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
208250 Issued in NY
Practice address
425 W 59TH St
New York, NY 10019-1104
Phone
(212) 590-2930
NPI assigned
Jun 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 208250 NY Primary

Addresses

Primary practice location

425 W 59TH St
New York, NY 10019-1104

Mailing address

1780 Broadway
Suite 1100
New York, NY 10019-1414
Phone (212) 590-2930

Other identifiers 1

IdentifierTypeStateIssuer
02150118MedicaidNY

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040708001228 NY Practitioner - Diagnostic Radiology 7911985700 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
New York College of Osteo Medicine of New York Institute of Technology, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lenox Hill Radiology and Medical Imaging Associates PCGroup PAC ID 2264424712, 245 clinicians

Practice addresses (Care Compare)

61 E 77TH St
New York, NY 10075-1817
Phone (212) 772-3111

Merit-based Incentive Payment System (MIPS)

Final score
81.08 of 100Reported as group
Quality
62.84
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
208250NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lenox Hill Radiology & Medical Imaging Associates, PC Diagnostic Radiology CurrentSince Oct 1, 2015 Accepting new patients
Hudson Valley Radiology Associates PLLC Diagnostic Radiology CurrentSince Sep 1, 2023 Accepting new patients
SLR Diagnostic Radiology, P.C. Diagnostic Radiology Past Accepting new patients
Beth Israel Medical Center Diagnostic Radiology Past Accepting new patients
SLR Diagnostic Radiology, P.C. Diagnostic Radiology Past Accepting new patients
Trustees of Columbia University in the City of New York Diagnostic Radiology Past Accepting new patients
East Manhattan Diagnostic Imaging, P.C. Diagnostic Radiology Past Accepting new patients
Bimc Faculty Practice Past Accepting new patients

Locations

27443 Network Pl
Chicago, IL 60673

8940 56th Ave
Flushing, NY 11373
Phone (718) 335-5532

18 Squadron Blvd
New City, NY 10956
Phone (845) 368-3002

315 W 57th St
Ste LL4
New York, NY 10019
Phone (212) 698-5300

61 E 77th St
New York, NY 10075
Phone (212) 772-2130

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457390171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1780 BROADWAY",
            "address_2": "SUITE 1100",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191414",
            "telephone_number": "212-590-2930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W 59TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191104",
            "telephone_number": "212-590-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICHT",
        "first_name": "MICHELE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "208250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02150118",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.