NPIMap

Organization Active NPI

PJS Medical Diagnostic PLLC

  • Diagnostic Radiology Physician
  • Port Jefferson Station, NY
National Provider Identifier
1609110295
Registry record updated Dec 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
PJS MEDICAL DIAGNOSTIC PLLC
Practice address
650 Hallock Avenue
Port Jefferson Station, NY 11776-1256
Phone
(631) 446-4700
Fax
(888) 972-3585
NPI assigned
Nov 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2013

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

Authorized official

Name
Mark J Lodespoto, MD
Title
Owner
Phone
(631) 446-4700

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

650 Hallock Avenue
Port Jefferson Station, NY 11776-1256

Mailing address

650 Hallock Avenue
Port Jefferson Station, NY 11776-1256
Phone (631) 446-4700

National Provider Directory

National Provider Directory

Locations

2090 Deer Park Ave
Deer Park, NY 11729
Phone (631) 667-9440

4 Technology Dr
Ste 130
East Setauket, NY 11733
Phone (631) 479-3743

1051 Adams Ave
Franklin Square, NY 11010
Phone (516) 354-4858

2835 Middle Country Rd
Lake Grove, NY 11755
Phone (631) 467-3564

290 Sunrise Hwy
Lindenhurst, NY 11757
Phone (631) 226-3600

2094 Merrick Ave
Merrick, NY 11566
Phone (516) 375-5904

555 Route 25A
Miller Place, NY 11764
Phone (631) 744-0202

848 Hicksville Rd
North Massapequa, NY 11758
Phone (516) 731-3210

107 N Ocean Ave
Patchogue, NY 11772
Phone (631) 654-5004

100 Manetto Hill Rd
Ste 312
Plainview, NY 11803
Phone (516) 513-1720

200 Belle Terre Rd
#110
Port Jefferson, NY 11777
Phone (631) 298-4008

10 Medical Dr
Ste B
Port Jefferson Station, NY 11776
Phone (631) 474-1111

650 Hallock Ave
Ste 1
Port Jefferson Station, NY 11776

100 N Country Rd
Ste 1
Setauket, NY 11733

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1353369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387497600000",
    "number": "1609110295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 HALLOCK AVENUE",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761256",
            "telephone_number": "631-446-4700",
            "fax_number": "888-972-3585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 HALLOCK AVENUE",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761256",
            "telephone_number": "631-446-4700",
            "fax_number": "888-972-3585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PJS MEDICAL DIAGNOSTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-20",
        "last_updated": "2013-12-20",
        "status": "A",
        "authorized_official_last_name": "LODESPOTO",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-446-4700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2013; 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.