NPIMap

Organization Active NPI

Diagnostic X-Ray Service, Inc.

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Buffalo, NY
National Provider Identifier
1699853606
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X
Legal business name
DIAGNOSTIC X-RAY SERVICE, INC.
Practice address
2828 Main St
Buffalo, NY 14214-1722
Phone
(814) 459-6280
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Authorized official

Name
Jacob Russell Wuerstle
Title
President
Phone
(814) 459-6280

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X Primary

Addresses

Primary practice location

2828 Main St
Buffalo, NY 14214-1722

Mailing address

1769 W 26TH St
Erie, PA 16508-1256
Phone (800) 446-9729

Other practice location 1

4242 Ridge Lea Rd Ste 1
Amherst, NY 14226-5122
Phone (814) 459-6280

Other identifiers 2

IdentifierTypeStateIssuer
01676219MedicaidNY
02996936MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040816001177 NY Part B Supplier - Portable X-Ray Supplier 8921904731 Practice locations: Buffalo, NY

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Diagnostic X-Ray Service Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2828 Main St
Ste 3
Buffalo, NY 14214
Phone (716) 362-8775

777 Maple Rd
Williamsville, NY 14221
Phone (716) 631-0777

Practitioners & affiliated clinicians

Practitioners 6

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": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727049600000",
    "number": "1699853606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1769 W 26TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165081256",
            "telephone_number": "800-446-9729",
            "fax_number": "814-459-6386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142141722",
            "telephone_number": "814-459-6280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4242 Ridge Lea Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Amherst",
            "state": "NY",
            "postal_code": "142265122",
            "country_code": "US",
            "telephone_number": "814-459-6280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DIAGNOSTIC X-RAY SERVICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A",
        "authorized_official_last_name": "WUERSTLE",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-459-6280"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01676219",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02996936",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.