NPIMap

Organization Active NPI

Northstar Imaging Medical Group, Inc.

  • Diagnostic Radiology Physician
  • Susanville, CA
National Provider Identifier
1598818858
Registry record updated Jul 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
NORTHSTAR IMAGING MEDICAL GROUP, INC.
Practice address
1800 Spring Ridge Dr
Susanville, CA 96130-6100
Phone
(530) 252-2111
NPI assigned
Jan 19, 2007
Last updated
Jul 16, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2014

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

Authorized official

Name
Dr. Robert G Leckie, MDNPI 1861490559
Title
Treasurer
Phone
(775) 813-8054

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

1800 Spring Ridge Dr
Susanville, CA 96130-6100

Mailing address

PO Box 32936
Knoxville, TN 37930-2936
Phone (877) 905-6553

National Provider Directory

National Provider Directory

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405468800000",
    "number": "1598818858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32936",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379302936",
            "telephone_number": "877-905-6553",
            "fax_number": "608-788-8799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 SPRING RIDGE DR",
            "city": "SUSANVILLE",
            "state": "CA",
            "postal_code": "961306100",
            "telephone_number": "530-252-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSTAR IMAGING MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2014-07-16",
        "status": "A",
        "authorized_official_last_name": "LECKIE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "775-813-8054",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Susanville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; 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.