Individual provider Active NPI

Daniel Schlusselberg, MD

  • Diagnostic Radiology Physician
  • Rego Park, NY
National Provider Identifier
1659347110
Registry record updated May 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
144156 Issued in NY
Practice address
6243 Woodhaven Blvd
Rego Park, NY 11374-3731
Phone
(718) 507-4700
Fax
(718) 397-0422
NPI assigned
Feb 24, 2006
Last updated
May 4, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2009

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 144156 NY Primary

Addresses

Primary practice location

6243 Woodhaven Blvd
Rego Park, NY 11374-3731

Mailing address

105 Shelley Cir
Monsey, NY 10952-1444
Phone (845) 362-0408

Other identifiers 1

IdentifierTypeStateIssuer
01744912MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040311001133 NY Practitioner - Diagnostic Radiology 3173424157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Texas Medical School at San Antonio, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2308 30TH Ave
Astoria, NY 11102-3494

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Queens Radiology, PC Diagnostic Radiology CurrentSince Jul 27, 2007 Accepting new patients
Northern Boulevard Imaging, MDPC Past Accepting new patients
CMC Radiological Services PC Diagnostic Radiology Past Accepting new patients
Central Radiology Services Diagnostic Radiology Past Accepting new patients
CMC Radiological Services PC Diagnostic Radiology Past Accepting new patients
Radiology Associates of Poughkeepsie PLLC Diagnostic Radiology Past Accepting new patients
Charles J Demarco, PC Dba Allied Health Imaging Diagnostic Radiology Past Accepting new patients
Middle Village Diagnostic Imaging PC Diagnostic Radiology Past Accepting new patients
Richard J Claps M.D. & Associates P.a. Diagnostic Radiology PastSince Oct 17, 2014 Accepting new patients

Locations

2308 30th Ave
Long Island City, NY 11102
Phone (718) 726-2000

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241395200000",
    "number": "1659347110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SHELLEY CIR",
            "city": "MONSEY",
            "state": "NY",
            "postal_code": "109521444",
            "telephone_number": "845-362-0408",
            "fax_number": "845-362-6773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6243 WOODHAVEN BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743731",
            "telephone_number": "718-507-4700",
            "fax_number": "718-397-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLUSSELBERG",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2009-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "144156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01744912",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

Verify at the official NPI Registry.