NPIMap

Organization Active NPI

Lakes Radiology PLLC

  • Diagnostic Radiology Physician
  • Hornell, NY
National Provider Identifier
1710937727
Registry record updated Feb 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
167192 Issued in NY
Legal business name
LAKES RADIOLOGY PLLC
Practice address
411 Canisteo St
Radiology
Hornell, NY 14843-2104
Phone
(607) 324-8255
Fax
(607) 324-8774
NPI assigned
May 11, 2006
Last updated
Feb 4, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2011

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

Authorized official

Name
Dr. Iddo Netanyahu, MDNPI 1013969526
Title
Ceo
Phone
(607) 324-8255

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 167192 NY Primary

Addresses

Primary practice location

411 Canisteo St
Radiology
Hornell, NY 14843-2104

Mailing address

7 Erie Ave
Radiology
Hornell, NY 14843-1909
Phone (607) 324-8255

Other identifiers 3

IdentifierTypeStateIssuer
000914685002OtherNYHEALTHNOW
02412119MedicaidNY
G0187663370OtherNYBCBS OF CNY

National Provider Directory

National Provider Directory

Locations

1626 Clark Street Rd
Ste 30
Auburn, NY 13021
Phone (315) 939-0645

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296777600000",
    "number": "1710937727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 ERIE AVE",
            "address_2": "RADIOLOGY",
            "city": "HORNELL",
            "state": "NY",
            "postal_code": "148431909",
            "telephone_number": "607-324-8255",
            "fax_number": "607-324-8774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 CANISTEO ST",
            "address_2": "RADIOLOGY",
            "city": "HORNELL",
            "state": "NY",
            "postal_code": "148432104",
            "telephone_number": "607-324-8255",
            "fax_number": "607-324-8774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKES RADIOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2011-02-04",
        "status": "A",
        "authorized_official_last_name": "NETANYAHU",
        "authorized_official_first_name": "IDDO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "607-324-8255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "167192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNOW",
            "identifier": "000914685002",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02412119",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF CNY",
            "identifier": "G0187663370",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hornell, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2011; 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.