Individual provider Active NPI

John Eric Ditzenberger, MD

  • Diagnostic Radiology Physician
  • Poughkeepsie, NY
National Provider Identifier
1508872649
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2383281 Issued in NY
Practice address
695 Dutchess Tpke
Suite 105
Poughkeepsie, NY 12603-6442
Phone
(888) 647-5979
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 25MA07167900 NJ
Diagnostic Radiology Physician 2085R0202X 2383281 NY Primary

Addresses

Primary practice location

695 Dutchess Tpke
Suite 105
Poughkeepsie, NY 12603-6442

Mailing address

506 Melrose Ave
Middlesex, NJ 08846-2342
Phone (732) 748-8893

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
25MA07167900NJMDDiagnostic Radiology Physician
2383281NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
River Radiology PLLC Diagnostic Radiology Past Accepting new patients
Catskill Regional Medical Center Past Accepting new patients
Sound Shore Physician Services Past Accepting new patients
Ulster Radiologic Associates, PC Past Accepting new patients

Organizations & group practices 4

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508872649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 MELROSE AVE",
            "city": "MIDDLESEX",
            "state": "NJ",
            "postal_code": "088462342",
            "telephone_number": "732-748-8893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 DUTCHESS TPKE",
            "address_2": "SUITE 105",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126036442",
            "telephone_number": "888-647-5979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITZENBERGER",
        "first_name": "JOHN",
        "middle_name": "ERIC",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA07167900",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "2383281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.