Individual provider Active NPI

Jonathan Marc Latzman, M.D.

  • Vascular & Interventional Radiology Physician
  • Bronx, NY
National Provider Identifier
1689960031
Registry record updated May 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
288219-1 Issued in NY
Practice address
111 E 210TH St
Department of Radiology
Bronx, NY 10467-2401
Phone
(718) 920-5506
NPI assigned
Jun 23, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 288219-1 NY Primary

Addresses

Primary practice location

111 E 210TH St
Department of Radiology
Bronx, NY 10467-2401

Mailing address

1976 Marcus Avenue
Suite C101
New Hyde Park, NY 11042

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170606002688 NY Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 5294002655 Reassigns benefits to 4 organizations
I20240603000821 NJ Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 5294002655 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mskcc Radiology GroupGroup PAC ID 3971494683, 192 clinicians

Practice addresses (Care Compare)

1275 York Ave
New York, NY 10065-6007
Phone (212) 639-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
65.9 of 100Reported as group
Quality
81.6
Improvement activities
40
Cost
10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
288219-1NYMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Radiology Associates, LLP Vascular & Interventional Radiology CurrentSince Jul 17, 2017 Accepting new patients
MSK Bergen Vascular & Interventional Radiology CurrentSince Apr 23, 2024 Accepting new patients
Southside Faculty Medical Affiliates University Faculty Practice Corp CurrentSince Aug 1, 2021 Accepting new patients
MSK Monmouth Vascular & Interventional Radiology CurrentSince Apr 23, 2024 Accepting new patients
North Shore-Lij Medical PC CurrentSince Jul 2, 2018 Accepting new patients
Memorial Sloan Kettering Cancer Center at Basking Ridge New Jersey Vascular & Interventional Radiology CurrentSince Apr 23, 2024 Accepting new patients

Locations

136 Mountainview Blvd
Basking Ridge, NJ 07920
Phone (908) 542-3000

480 Red Hill Rd
Middletown, NJ 07748
Phone (908) 542-3007

225 Summit Ave
Montvale, NJ 07645
Phone (908) 542-3336

111 E 210th St
Bronx, NY 10467

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Fl 1
Manhasset, NY 11030
Phone (516) 562-2252

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

633 3rd Ave
Fl 4
New York, NY 10017
Phone (646) 227-3764

300 Community Dr
Plandome, NY 11030

1220 Hicksville Rd
Seaford, NY 11783

224 Harrison St
Ste 601
Syracuse, NY 13202
Phone (315) 464-6672

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: jlatzman30599@mskcc.direct-ci.com

Organizations & group practices 7

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 5

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": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527033600000",
    "number": "1689960031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1976 MARCUS AVENUE",
            "address_2": "SUITE C101",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "11042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "718-920-5506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATZMAN",
        "first_name": "JONATHAN",
        "middle_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-23",
        "last_updated": "2018-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NY",
            "license": "288219-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.