Individual provider Active NPI

Douglas Reese Cole, M.D.

  • Diagnostic Radiology Physician
  • Bay Shore, NY
National Provider Identifier
1508897851
Registry record updated Sep 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
192172 Issued in NY
Practice address
375 E Main St
Suite 12
Bay Shore, NY 11706-8418
Phone
(631) 665-2264
Fax
(631) 665-5535
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2007

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 192172 NY Primary

Addresses

Primary practice location

375 E Main St
Suite 12
Bay Shore, NY 11706-8418

Mailing address

375 E Main St
Suite 12
Bay Shore, NY 11706-8418
Phone (631) 665-2264

Other identifiers 1

IdentifierTypeStateIssuer
1713377MedicaidNY

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lenox Hill Radiology & Medical Imaging Associates, PC Diagnostic Radiology Past Accepting new patients
Stony Brook Radiologic Services PC Diagnostic Radiology Past Accepting new patients
Magnetic Resonance Imaging of Huntington, P.C. Diagnostic Radiology Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190332800000",
    "number": "1508897851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 E MAIN ST",
            "address_2": "SUITE 12",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068418",
            "telephone_number": "631-665-2264",
            "fax_number": "631-665-5535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 E MAIN ST",
            "address_2": "SUITE 12",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068418",
            "telephone_number": "631-665-2264",
            "fax_number": "631-665-5535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "DOUGLAS",
        "middle_name": "REESE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2007-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "192172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1713377",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.