NPIMap

Organization Active NPI

Peninsula Radiology Associates P C

  • Diagnostic Radiology Physician
  • Far Rockaway, NY
National Provider Identifier
1700896602
Registry record updated May 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
PENINSULA RADIOLOGY ASSOCIATES P C
Practice address
5115 Beach Channel Dr
Far Rockaway, NY 11691-1042
Phone
(718) 734-2616
Fax
(212) 563-0605
NPI assigned
Aug 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2010

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

Authorized official

Name
Dr. Stanley Sprecher, M.D.
Title
Partner
Phone
(718) 734-2616

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085B0100X
Pediatric Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085P0229X
Diagnostic Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0202X Primary
Vascular & Interventional Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0204X

Addresses

Primary practice location

5115 Beach Channel Dr
Far Rockaway, NY 11691-1042

Mailing address

80 Marcus Dr
Attn: Provider Enrollment
Melville, NY 11747-4230
Phone (631) 391-8366

Other identifiers 1

IdentifierTypeStateIssuer
01470864MedicaidNY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273017600000",
    "number": "1700896602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 MARCUS DR",
            "address_2": "ATTN: PROVIDER ENROLLMENT",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474230",
            "telephone_number": "631-391-8366",
            "fax_number": "631-454-4163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5115 BEACH CHANNEL DR",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116911042",
            "telephone_number": "718-734-2616",
            "fax_number": "212-563-0605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA RADIOLOGY ASSOCIATES P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2010-05-05",
        "status": "A",
        "authorized_official_last_name": "SPRECHER",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "718-734-2616",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Body Imaging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Pediatric Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01470864",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.