Individual provider Active NPI

Nolan J Kagetsu, M.D

  • Diagnostic Radiology Physician
  • New York, NY
National Provider Identifier
1467489625
Registry record updated Nov 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
166260 Issued in NY
Practice address
1000 10TH Avenue
New York, NY 10019
Phone
(212) 590-2930
Fax
(212) 590-2982
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiological Physics Physician 2085R0205X 166260 NY
Diagnostic Radiology Physician 2085R0202X 166260 NY Primary

Addresses

Primary practice location

1000 10TH Avenue
New York, NY 10019

Mailing address

10 Exchange PL
14TH Floor - WSBS
Jersey City, NJ 07302-3918
Phone (212) 590-2982

Other identifiers 1

IdentifierTypeStateIssuer
01256880MedicaidNY

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
I20041030000001 NY Practitioner - Diagnostic Radiology 0840252029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Albany Medical College of Union University, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fpa Hospital BasedGroup PAC ID 4789826694, 423 clinicians

Practice addresses (Care Compare)

10 Union SQ E
New York, NY 10003-3314
Phone (212) 241-8395

100 TH St and Madison Ave
New York, NY 10029-6503
Phone (212) 241-6500

1000 10TH Ave
New York, NY 10019-1147
Phone (212) 241-6426

1111 Amsterdam Ave
New York, NY 10025-1716
Phone (212) 241-6426

1176 5TH Ave
New York, NY 10029-6503
Phone (212) 241-8395

1470 Madison Ave
New York, NY 10029-6542
Phone (212) 241-8426

16 W 25TH St
New York, NY 10019-3584
Phone (800) 627-4470

3131 Kings Hwy
FL 1
Brooklyn, NY 11234-2644
Phone (718) 951-2930

3201 Kings Hwy
Brooklyn, NY 11234-2625
Phone (718) 252-3000

325 W 15TH St
New York, NY 10011-5903
Phone (212) 604-6009

425 W 59TH St
New York, NY 10019-8022
Phone (212) 241-8333

5 E 98TH St
New York, NY 10029-6501

787 11TH Ave
New York, NY 10019-3584
Phone (800) 627-4470

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
166260NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fpa Hospital Based Diagnostic Radiology CurrentSince Apr 12, 2017 Accepting new patients
Fpa Hospital Based Current Accepting new patients
Fpa Hospital Based CurrentSince Apr 12, 2017 Accepting new patients
SLR Diagnostic Radiology, P.C. Diagnostic Radiology Past Accepting new patients
East Manhattan Diagnostic Imaging, 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
Bimc Faculty Practice PastSince Aug 28, 2004 Accepting new patients

Locations

3712 82nd St
Jackson Hts, NY 11372
Phone (718) 879-1600

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

1111 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2309

425 W 59th St
New York, NY 10019
Phone (212) 376-3180

325 W 15th St
New York, NY 10011
Phone (212) 523-5938

1470 Madison Ave
New York, NY 10029
Phone (212) 241-0806

1090 Amsterdam Ave
#3
New York, NY 10025
Phone (212) 523-1784

1176 5th Ave
New York, NY 10029
Phone (212) 241-6237

55 E 34th St
New York, NY 10016
Phone (212) 252-6131

425 W 59th St
#6
New York, NY 10019
Phone (212) 532-7533

Networks

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

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.

Hospital & facility affiliations 12

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

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320278400000",
    "number": "1467489625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 EXCHANGE PL",
            "address_2": "14TH FLOOR - WSBS",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073023918",
            "telephone_number": "212-590-2982",
            "fax_number": "212-590-2982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 10TH AVENUE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10019",
            "telephone_number": "212-590-2930",
            "fax_number": "212-590-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAGETSU",
        "first_name": "NOLAN",
        "middle_name": "J",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2011-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0205X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiological Physics",
            "state": "NY",
            "license": "166260",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "166260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01256880",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.