NPIMap

Organization Active NPI

Northern Radiology Imaging Center, PLLC

  • Diagnostic Radiology Physician
  • Watertown, NY
National Provider Identifier
1750370805
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
NORTHERN RADIOLOGY IMAGING CENTER, PLLC
Practice address
120 Washington St Ste 406
Watertown, NY 13601-3330
Phone
(315) 786-5047
Fax
(315) 786-5010
NPI assigned
Oct 20, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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

Authorized official

Name
Amanda Sue Bisig
Title
Chief Operating Officer
Phone
(315) 786-5047

Specialties & licenses 1

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

Addresses

Primary practice location

120 Washington St Ste 406
Watertown, NY 13601-3330

Mailing address

1571 Washington Street
Suite 101
Watertown, NY 13601
Phone (315) 786-5046

National Provider Directory

National Provider Directory

Locations

629 Washington St
Ste 101
Watertown, NY 13601
Phone (315) 786-5046

1571 Washington St
Ste 101
Watertown, NY 13601
Phone (315) 786-5046

Practitioners & affiliated clinicians

Practitioners 25

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 25

NPI Registry JSON

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613520000000",
    "number": "1750370805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1571 WASHINGTON STREET",
            "address_2": "SUITE 101",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "13601",
            "telephone_number": "315-786-5046",
            "fax_number": "315-786-5043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 WASHINGTON ST STE 406",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136013330",
            "telephone_number": "315-786-5047",
            "fax_number": "315-786-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN RADIOLOGY IMAGING CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-20",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A",
        "authorized_official_last_name": "BISIG",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "315-786-5047"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; 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.