Individual provider Active NPI

Richard M Rozanski, MD

  • Diagnostic Radiology Physician
  • Syracuse, NY
National Provider Identifier
1467451013
Registry record updated Jul 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
126928 Issued in NY
Practice address
736 Irving Ave
Syracuse, NY 13210-1687
Phone
(315) 470-7551
Fax
(315) 470-2719
NPI assigned
Jul 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2012

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 126928 NY Primary

Addresses

Primary practice location

736 Irving Ave
Syracuse, NY 13210-1687

Mailing address

5008 Brittonfield Pkwy
Suite 100
East Syracuse, NY 13057-9248
Phone (315) 234-7600

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

State licenses

LicenseStateTypeSpecialty
126928NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genesee Valley Group Health Association Past Accepting new patients
Mobile Diagnostic Testing Services Inc Past Accepting new patients

Organizations & group practices 2

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": "1121558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341964800000",
    "number": "1467451013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5008 BRITTONFIELD PKWY",
            "address_2": "SUITE 100",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579248",
            "telephone_number": "315-234-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 IRVING AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132101687",
            "telephone_number": "315-470-7551",
            "fax_number": "315-470-2719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROZANSKI",
        "first_name": "RICHARD",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-17",
        "last_updated": "2012-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "126928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2012; 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.