Individual provider Active NPI

Nicholas C Trasolini, M.D.

  • Diagnostic Radiology Physician
  • Liverpool, NY
National Provider Identifier
1487646394
Registry record updated Mar 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
184206 Issued in NY
Practice address
5100 W Taft Rd
Suite 2a
Liverpool, NY 13088-3807
Phone
(315) 452-2555
Fax
(315) 452-2559
NPI assigned
Aug 17, 2005
Last updated
Mar 25, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2014

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 184206 NY Primary

Addresses

Primary practice location

5100 W Taft Rd
Suite 2a
Liverpool, NY 13088-3807

Mailing address

4567 Crossroads Park Dr
2ND Floor
Liverpool, NY 13088-3589
Phone (315) 295-2100

Other identifiers 4

IdentifierTypeStateIssuer
00555500MedicaidNY
01426686MedicaidNY
00555440MedicaidNY
02224500MedicaidNY

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
I20070922000003 NY Practitioner - Diagnostic Radiology 3870498249 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
184206NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Josephs Imaging Associates PLLC Diagnostic Radiology CurrentSince Aug 22, 1994 Accepting new patients
Prospect Hill Radiology Group P C Diagnostic Radiology CurrentSince Jul 1, 1993 Accepting new patients
Island Sports Physical Therapy of Glen Cove PC PastSince Aug 23, 2001 Accepting new patients

Locations

615 N Seward Ave
Auburn, NY 13021
Phone (315) 253-9749

4109 Medical Center Dr
Fayetteville, NY 13066
Phone (315) 329-7555

4109 Medical Center Dr
Ste 109
Fayetteville, NY 13066

5100 W Taft Rd
Ste 2A
Liverpool, NY 13088
Phone (315) 452-2555

8200 Oswego Rd
Liverpool, NY 13090
Phone (315) 452-2555

300 State Route 104
Ste 3
Oswego, NY 13126
Phone (315) 216-6060

104 Union Ave
Ste 905
Syracuse, NY 13203
Phone (315) 703-5114

109 Pine St
Syracuse, NY 13210
Phone (315) 391-6263

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395705600000",
    "number": "1487646394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4567 CROSSROADS PARK DR",
            "address_2": "2ND FLOOR",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883589",
            "telephone_number": "315-295-2100",
            "fax_number": "315-295-2125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W TAFT RD",
            "address_2": "SUITE 2A",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883807",
            "telephone_number": "315-452-2555",
            "fax_number": "315-452-2559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRASOLINI",
        "first_name": "NICHOLAS",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2014-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "184206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00555500",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01426686",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00555440",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02224500",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

Verify at the official NPI Registry.