Individual provider Active NPI

Marc Jouandet, MD

  • Diagnostic Radiology Physician
  • Poughkeepsie, NY
National Provider Identifier
1730180787
Registry record updated Aug 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
179251 Issued in NY
Practice address
695 Dutchess Tpke Ste 105
Poughkeepsie, NY 12603-6443
Phone
(888) 647-5979
Fax
(888) 847-0818
NPI assigned
Aug 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 179251 NY Primary

Addresses

Primary practice location

695 Dutchess Tpke Ste 105
Poughkeepsie, NY 12603-6443

Mailing address

695 Dutchess Tpke Ste 105
Poughkeepsie, NY 12603-6443
Phone (888) 647-5979

Other identifiers 1

IdentifierTypeStateIssuer
01625534MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20170124002348 AZ Practitioner - Diagnostic Radiology 3870780380 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Beverly Radiology Medical Group III Diagnostic Radiology CurrentSince Jan 15, 2017 Accepting new patients
Kern Radiology Medical Group, Inc Diagnostic Radiology Past Accepting new patients
Borg Imaging Group LLP Past Accepting new patients

Locations

2501 E Southern Ave
Ste 811
Tempe, AZ 85282
Phone (480) 820-2021

1160 Pittsford Victor Rd
Ste D2
Pittsford, NY 14534
Phone (585) 218-8007

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1730180787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 DUTCHESS TPKE STE 105",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126036443",
            "telephone_number": "888-647-5979",
            "fax_number": "888-847-0818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 DUTCHESS TPKE STE 105",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126036443",
            "telephone_number": "888-647-5979",
            "fax_number": "888-847-0818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOUANDET",
        "first_name": "MARC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "179251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01625534",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

Verify at the official NPI Registry.