NPIMap

Organization Active NPI

New York Private Medical Imaging Practice, PLLC

  • Specialist
  • New York, NY
National Provider Identifier
1740459593
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
NEW YORK PRIVATE MEDICAL IMAGING PRACTICE, PLLC
Practice address
106 E 61St St
New York, NY 10065-8102
Phone
(212) 772-7637
Fax
(212) 288-1852
NPI assigned
Feb 26, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

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

Authorized official

Name
Mr. Donovan Spamer
Title
VP of Operations
Phone
(212) 772-7637

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

106 E 61St St
New York, NY 10065-8102

Mailing address

106 E 61St St
New York, NY 10065-8102
Phone (212) 772-7637

Other practice location 1

52 E 78th St
New York, NY 10075-1810
Phone (212) 772-7637

Other identifiers 1

IdentifierTypeStateIssuer
A100000024OtherNYMEDICARE (NY)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080725000656 NY Part B Supplier - Clinic/Group Practice 1355414178 Receives reassigned benefits from 25 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

27745 Network Pl
Chicago, IL 60673

345 Woodcliff Dr
Ste 2A
Fairport, NY 14450

488 Madison Ave
New York, NY 10022
Phone (212) 755-7656

Practitioners & affiliated clinicians

Practitioners 51

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

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1203984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593043200000",
    "number": "1740459593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 E 61ST ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100658102",
            "telephone_number": "212-772-7637",
            "fax_number": "212-288-1852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 E 61ST ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100658102",
            "telephone_number": "212-772-7637",
            "fax_number": "212-288-1852"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "52 E 78th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100751810",
            "country_code": "US",
            "telephone_number": "212-772-7637",
            "fax_number": "212-288-1852",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEW YORK PRIVATE MEDICAL IMAGING PRACTICE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-26",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A",
        "authorized_official_last_name": "SPAMER",
        "authorized_official_first_name": "DONOVAN",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "212-772-7637",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE (NY)",
            "identifier": "A100000024",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.