Individual provider Active NPI

Julie Sharon Mitnick, M.D

  • Diagnostic Radiology Physician
  • New York, NY
National Provider Identifier
1770554883
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
118419-1 Issued in NY
Practice address
650 1St Ave
2ND Floor
New York, NY 10016-3240
Phone
(212) 213-3208
Fax
(212) 683-3092
NPI assigned
Jan 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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 118419-1 NY Primary

Addresses

Primary practice location

650 1St Ave
2ND Floor
New York, NY 10016-3240

Mailing address

650 1St Ave
2ND Floor
New York, NY 10016-3240
Phone (212) 213-3208

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 1, 2013 through Feb 1, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
118419-1NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York Private Medical Imaging Practice, PLLC PastSince Jul 1, 2019 Accepting new patients

Organizations & group practices 1

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": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205712000000",
    "number": "1770554883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 1ST AVE",
            "address_2": "2ND FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163240",
            "telephone_number": "212-213-3208",
            "fax_number": "212-683-3092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 1ST AVE",
            "address_2": "2ND FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163240",
            "telephone_number": "212-213-3208",
            "fax_number": "212-683-3092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITNICK",
        "first_name": "JULIE",
        "middle_name": "SHARON",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-27",
        "last_updated": "2008-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "118419-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.