Individual provider Active NPI

Edward Stephen Ostrowski, MD

  • Diagnostic Radiology Physician
  • Dalton, GA
National Provider Identifier
1467415901
Registry record updated Feb 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
73603 Issued in GA
Practice address
1502 North Thornton Avenue
Dalton, GA 30720-3064
Phone
(706) 278-9729
Fax
(706) 226-9378
NPI assigned
Apr 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2016

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 73603 GA Primary

Addresses

Primary practice location

1502 North Thornton Avenue
Dalton, GA 30720-3064

Mailing address

P.O. Box 1207
Dalton, GA 30722-1207
Phone (706) 278-9729

Other identifiers 1

IdentifierTypeStateIssuer
2157519MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baystate Medical Practices, Inc Past Accepting new patients
Advanced Imaging of Port Charlotte Diagnostic Radiology Past Accepting new patients
Baystate Affiliated Practice Organization Past Accepting new patients
Burlington Radiological Associates Diagnostic Radiology Past Accepting new patients
Advanced Imaging of Port Charlotte LLC Diagnostic Radiology PastSince Dec 1, 2004 Accepting new patients

Organizations & group practices 5

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": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455580800000",
    "number": "1467415901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1207",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307221207",
            "telephone_number": "706-278-9729",
            "fax_number": "706-226-9378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 NORTH THORNTON AVENUE",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307203064",
            "telephone_number": "706-278-9729",
            "fax_number": "706-226-9378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSTROWSKI",
        "first_name": "EDWARD",
        "middle_name": "STEPHEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2016-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "73603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2157519",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; 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.