Individual provider Active NPI

David Podhaizer, M.D.

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1790044485
Registry record updated Feb 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
255453 Issued in MA
Practice address
820 Harrison Ave # FGH3
Boston, MA 02118-2905
Phone
(617) 638-6610
NPI assigned
May 15, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X 255453 MA Primary

Addresses

Primary practice location

820 Harrison Ave # FGH3
Boston, MA 02118-2905

Mailing address

820 Harrison Ave # FGH3
Boston, MA 02118-2905
Phone (617) 638-6610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180604001510 NY Practitioner - Diagnostic Radiology 7911139704 Reassigns benefits to 5 organizations
I20260103510122 NJ Practitioner - Diagnostic Radiology 7911139704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
New York Medical College, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore Hematology Oncology Associates PCGroup PAC ID 1456243641, 474 clinicians
Sunset Park Radiology PCGroup PAC ID 6608247291, 32 clinicians
Radiology Associates of Main Street PCGroup PAC ID 5799677522, 52 clinicians
Valley Physician Services PCGroup PAC ID 3577857333, 593 clinicians

Practice addresses (Care Compare)

1500 Route 112
Port Jefferson Station, NY 11776-8054
Phone (631) 751-3000

15459 Riverside Dr
Beechhurst, NY 11357-1339
Phone (212) 965-9888

2 Robbins Dr
East Williston, NY 11596-2008
Phone (718) 428-1500

21 Ivy Close
Forest Hills, NY 11375-6020
Phone (718) 670-1050

3225 Francis Lewis Blvd
Flushing, NY 11358-1922
Phone (718) 428-1500

4 Valley Health PLZ
Paramus, NJ 07652-3619
Phone (800) 825-5391

4705 Ctr Blvd
Apt 1614
Long Island City, NY 11109-5686
Phone (201) 447-8000

48 Route 25a
Smithtown, NY 11787-1431
Phone (631) 751-3000

5521 8TH Ave
FL 6
Brooklyn, NY 11220-3515
Phone (718) 928-2588

5645 Main St
Flushing, NY 11355-5045
Phone (718) 428-1500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
255453MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Main Street Radiology at Bayside LLC Diagnostic Radiology CurrentSince Jun 1, 2018 Accepting new patients
Radiology Associates of Main Street PC Diagnostic Radiology CurrentSince Jun 1, 2018 Accepting new patients
North Shore Hematology Oncology Associates PC CurrentSince Nov 1, 2023 Accepting new patients
Valley Physician Services PC CurrentSince Oct 3, 2025 Accepting new patients
Sunset Park Radiology PC Diagnostic Radiology CurrentSince Feb 20, 2024 Accepting new patients

Locations

5521 8th Ave
Fl 6
Brooklyn, NY 11220
Phone (718) 928-2588

3225 Francis Lewis Blvd
Flushing, NY 11358
Phone 61421018851070

7206 Northern Blvd
Jackson Heights, NY 11372
Phone (718) 670-1512

3016 30th Dr
Long Island City, NY 11102
Phone (718) 728-3376

1500 Route 112
Bldg 4
Port Jefferson Station, NY 11776
Phone (631) 574-8354

48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Organizations & group practices 5

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1337040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455667200000",
    "number": "1790044485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 HARRISON AVE # FGH3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182905",
            "telephone_number": "617-638-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 HARRISON AVE # FGH3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182905",
            "telephone_number": "617-638-6610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODHAIZER",
        "first_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-15",
        "last_updated": "2016-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "255453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.