Individual provider Active NPI

Christopher J Vaughn, MD

  • Diagnostic Radiology Physician
  • Liverpool, NY
National Provider Identifier
1497728091
Registry record updated May 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
210074 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
Feb 13, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 10

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 5

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

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
State University of Ny Upstate Medical University, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Imaging Associates PLLC 16 clinicians
Prospect Hill Radiology Group P C 16 clinicians
Mohawk Glen Radiology Associates of Cny PLLC 13 clinicians

Practice addresses (Care Compare)

104 Union Ave
Syracuse, NY 13203-1845
Phone (315) 703-5114

300 State Route 104
Suite 3
Oswego, NY 13126-2956
Phone (315) 216-6060

301 Prospect Ave
Syracuse, NY 13203-1807
Phone (315) 448-5274

4109 Medical Ctr Dr
Fayetteville, NY 13066-6600
Phone (315) 329-7555

4117 Medical Ctr Dr
Suite 117
Fayetteville, NY 13066-6600
Phone (315) 452-2555

5100 W Taft Rd
Liverpool, NY 13088-4841

5100 W Taft Rd
Suite 1a
Liverpool, NY 13088-3808
Phone (315) 334-9729

5301 W Genesee St
Suite 250
Camillus, NY 13031-2238
Phone (315) 344-9729

615 N Seward Ave
Auburn, NY 13021-2107
Phone (315) 760-3913

8200 Oswego Rd
Liverpool, NY 13090-1567
Phone (315) 452-2555

91 Perimeter Rd
Suite 110
Rome, NY 13441-4018
Phone (315) 334-9729

Hospital & facility affiliations

  • St Joseph'S Hospital Health Center Hospital, Syracuse, NY, CCN 330140
  • Crouse Hospital Hospital, Syracuse, NY, CCN 330203
  • University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241
  • Oswego Hospital Hospital, Oswego, NY, CCN 330218
  • Samaritan Medical Center Hospital, Watertown, NY, CCN 330157

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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20070615000581 NY Practitioner - Diagnostic Radiology 4082643382 Reassigns benefits to 6 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
210074NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mohawk Glen Radiology Associates of Cny PLLC Diagnostic Radiology CurrentSince May 2, 2011 Accepting new patients
Prospect Hill Radiology Group P C Diagnostic Radiology CurrentSince Jul 1, 2007 Accepting new patients
St. Josephs Imaging Associates PLLC Diagnostic Radiology CurrentSince Jul 1, 2007 Accepting new patients
Union Avenue Open MRI LLC CurrentSince Jan 1, 2024 Accepting new patients
Tra-Minw P S CurrentSince Jan 1, 2024 Accepting new patients
Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance CurrentSince Jan 1, 2024 Accepting new patients
Tra-Minw P S Past Accepting new patients
Albany Radiology Associate PC Diagnostic Radiology Past Accepting new patients
Medical Imaging Northwest - Good Samaritan Hospital Imaging Alliance Past Accepting new patients
Medical Imaging Center LLP Past Accepting new patients

Locations

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

5301 W Genesee St
Ste 250
Camillus, NY 13031
Phone (315) 344-9729

4109 Medical Center Dr
Ste 109
Fayetteville, NY 13066

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

4117 Medical Center Dr
Fayetteville, NY 13066
Phone (315) 329-4968

5100 W Taft Rd
Ste 1A
Liverpool, NY 13088
Phone (315) 334-9729

5100 W Taft Rd
Ste 2C
Liverpool, NY 13088
Phone (315) 452-2666

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

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

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

91 Perimeter Rd
Ste 110
Rome, NY 13441
Phone (315) 334-9729

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

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

222 15th Ave SE
Puyallup, WA 98372

2502 S Union Ave
Tacoma, WA 98405
Phone (253) 759-5900

Interoperability endpoints

  • Direct secure messaging: vchristopher2410202@direct.trinity-health.org

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 210074 NY Primary

Addresses

NPPES NPI Registry

Primary practice location

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

Mailing address

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

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
01821907MedicaidNY

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 28, 2014.

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401235200000",
    "number": "1497728091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4567 CROSSROADS PARK DR",
            "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": "VAUGHN",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2014-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "210074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01821907",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

Verify at the official NPI Registry.