NPIMap

Individual provider Active NPI

Bryan Henriques

  • Diagnostic Radiology Physician
  • New York, NY
National Provider Identifier
1619322666
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
35.149037 Issued in OH
Practice address
17 E 102ND St
New York, NY 10029-5204
Phone
(212) 659-8551
NPI assigned
Apr 27, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X 35.149037 OH Primary

Addresses

Primary practice location

17 E 102ND St
New York, NY 10029-5204

Mailing address

17 E 102ND St
New York, NY 10029-5204

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231002001422 NY Practitioner - Diagnostic Radiology 6406200914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Columbia University College of Physicians and Surgeons, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Radiology and Interventional Associates IncGroup PAC ID 8729976964, 251 clinicians

Practice addresses (Care Compare)

435 E 79TH St
New York, NY 10075-1034
Phone (614) 340-7740

Hospital & facility affiliations

  • Genesis Hospital Hospital, Zanesville, OH, CCN 360039
  • Ohiohealth Mansfield Hospital Hospital, Mansfield, OH, CCN 360118
  • Marietta Memorial Hospital Hospital, Marietta, OH, CCN 360147
  • Marion General Hospital Hospital, Marion, OH, CCN 360011
  • Dublin Methodist Hospital Hospital, Dublin, OH, CCN 360348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35.149037OHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Radiology and Interventional Associates Inc Diagnostic Radiology CurrentSince Sep 1, 2023 Accepting new patients

Locations

100 E Campus View Blvd
Ste 100
Columbus, OH 43235
Phone (412) 359-8743

Organizations & group practices 1

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1619322666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 E 102ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100295204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 E 102ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100295204",
            "telephone_number": "212-659-8551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRIQUES",
        "first_name": "BRYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-27",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35.149037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.