NPIMap

Organization Active NPI

Northern Radiology Associates, PC

  • Diagnostic Radiology Physician
  • Watertown, NY
National Provider Identifier
1609845924
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
NORTHERN RADIOLOGY ASSOCIATES, PC
Practice address
120 Washington St Ste 406
Watertown, NY 13601-3330
Phone
(315) 786-5047
Fax
(315) 786-5010
NPI assigned
Mar 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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

Authorized official

Name
Amanda Sue Bisig
Title
Chief Operating Officer
Phone
(315) 786-5047

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085N0904X
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X
Diagnostic Ultrasound PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085U0001X

Addresses

Primary practice location

120 Washington St Ste 406
Watertown, NY 13601-3330

Mailing address

120 Washington St Ste 406
Watertown, NY 13601-3330
Phone (315) 786-5047

National Provider Directory

National Provider Directory

Locations

2601 E Oakland Park Blvd
Ft Lauderdale, FL 33306
Phone (315) 786-5059

2287 Johnson Ave
Apt 3C
Bronx, NY 10463
Phone (917) 584-6573

120 Washington St
Ste 406
Watertown, NY 13601
Phone (315) 786-5059

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613520000000",
    "number": "1609845924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 WASHINGTON ST STE 406",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136013330",
            "telephone_number": "315-786-5047",
            "fax_number": "315-786-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 WASHINGTON ST STE 406",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136013330",
            "telephone_number": "315-786-5047",
            "fax_number": "315-786-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN RADIOLOGY ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-17",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A",
        "authorized_official_last_name": "BISIG",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "315-786-5047"
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Nuclear Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; 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.