NPIMap

Organization Active NPI

Olean Radiology, PC

  • Diagnostic Radiology Physician
  • Olean, NY
National Provider Identifier
1700829850
Registry record updated Jun 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
OLEAN RADIOLOGY, PC
Practice address
515 Main St
Olean General Hospital
Olean, NY 14760-1513
Phone
(315) 782-2620
Fax
(315) 788-4980
NPI assigned
Jun 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2020

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

Authorized official

Name
Glauco Maresca, MDNPI 1053370742
Title
President/Ceo
Phone
(315) 265-4924

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

515 Main St
Olean General Hospital
Olean, NY 14760-1513

Mailing address

251 Najoles Rd Ste a
Millersville, MD 21108-2519
Phone (443) 274-2888

Other identifiers 2

IdentifierTypeStateIssuer
0019538120001MedicaidPA
02244984MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA, MA, FL, OH, AZ, CO, VA, OK9 enrollments

Enrollment records 9

Enrollment IDStateProvider typePAC IDDetails
O20040508000177 NY Part B Supplier - Clinic/Group Practice 9133118862 Receives reassigned benefits from 75 practitioners
Practice locations: Vestal, NY; Potsdam, NY; Olean, NY; Dunkirk, NY
O20160624000397 CA Part B Supplier - Clinic/Group Practice 9133118862 Receives reassigned benefits from 1 practitioner
Practice locations: Santa Monica, CA
O20220926000880 MA Part B Supplier - Clinic/Group Practice 9133118862 Receives reassigned benefits from 3 practitioners
Practice locations: Auburndale, MA; Brookline, MA; Newburyport, MA; Wellesley, MA
O20230825002650 FL Part B Supplier - Clinic/Group Practice 9133118862 Receives reassigned benefits from 3 practitioners
Practice locations: Port St Lucie, FL; Palm City, FL; Fort Lauderdale, FL
O20230830002635 OH Part B Supplier - Clinic/Group Practice 9133118862 Receives reassigned benefits from 2 practitioners
Practice locations: Dublin, OH; Portsmouth, OH
O20230830003164 AZ Part B Supplier - Clinic/Group Practice 9133118862 Receives reassigned benefits from 2 practitioners
Practice locations: Cave Creek, AZ; Scottsdale, AZ
O20230831002956 CO Part B Supplier - Clinic/Group Practice 9133118862 Receives reassigned benefits from 1 practitioner
Practice locations: Colorado Springs, CO
O20250214002908 VA Part B Supplier - Clinic/Group Practice 9133118862 Receives reassigned benefits from 1 practitioner
Practice locations: Lynchburg, VA
O20250304003464 OK Part B Supplier - Clinic/Group Practice 9133118862 Practice locations: Edmond, OK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 91

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

View all 91

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590969600000",
    "number": "1700829850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 NAJOLES RD STE A",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211082519",
            "telephone_number": "443-274-2888",
            "fax_number": "443-274-2391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 MAIN ST",
            "address_2": "OLEAN GENERAL HOSPITAL",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "147601513",
            "telephone_number": "315-782-2620",
            "fax_number": "315-788-4980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLEAN RADIOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A",
        "authorized_official_last_name": "MARESCA",
        "authorized_official_first_name": "GLAUCO",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "315-265-4924",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019538120001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02244984",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olean, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2020; 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.