NPIMap

Organization Active NPI

Diagnostic X-Ray Service Inc

  • Physiological Laboratory
  • Buffalo, NY
National Provider Identifier
1750465423
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
DIAGNOSTIC X-RAY SERVICE INC
Practice address
2828 Main St
Buffalo, NY 14214-1722
Phone
(814) 459-6280
NPI assigned
Oct 25, 2006
Last updated
Sep 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Authorized official

Name
Mr. Jacob Russell Wuerstle
Title
President
Phone
(814) 459-6280

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X NU Primary

Addresses

Primary practice location

2828 Main St
Buffalo, NY 14214-1722

Mailing address

1769 W 26TH St
Erie, PA 16508-1256
Phone (800) 446-9729

Other practice location 1

4242 Ridge Lea Rd Ste 1
Amherst, NY 14226-5122
Phone (814) 459-6280

Other identifiers 2

IdentifierTypeStateIssuer
01676219MedicaidNY
02997253MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031211000662 NY Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 8921904731 Practice locations: Buffalo, NY

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Diagnostic X-Ray Service Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6010 N Bailey Ave
Ste 1A
Amherst, NY 14226
Phone (716) 634-2084

2828 Main St
Buffalo, NY 14214
Phone (716) 362-8775

2828 Main St
Ste 3
Buffalo, NY 14214
Phone (716) 362-8775

3507 Union Rd
Cheektowaga, NY 14225
Phone (716) 683-1881

777 Maple Rd
Ste 3
Williamsville, NY 14221
Phone (716) 634-4900

Practitioners & affiliated clinicians

Practitioners 21

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 21

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727049600000",
    "number": "1750465423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1769 W 26TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165081256",
            "telephone_number": "800-446-9729",
            "fax_number": "814-459-6386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142141722",
            "telephone_number": "814-459-6280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4242 Ridge Lea Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Amherst",
            "state": "NY",
            "postal_code": "142265122",
            "country_code": "US",
            "telephone_number": "814-459-6280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DIAGNOSTIC X-RAY SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A",
        "authorized_official_last_name": "WUERSTLE",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-459-6280",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01676219",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02997253",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; 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.