NPIMap

Organization Active NPI

Cmi Professional Services

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Utica, NY
National Provider Identifier
1790701167
Registry record updated Jul 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
Legal business name
CMI PROFESSIONAL SERVICES
Practice address
107 Business Park Dr
Utica, NY 13502-6303
Phone
(315) 792-4666
Fax
(315) 792-9698
NPI assigned
Jul 15, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mr. Steven Louis Fossaceca, RT R MR
Title
Business Manager
Phone
(315) 792-4666

Practitioners 34

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

View all 34

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA, AZ, PA, FL, TX6 enrollments

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
O20041217000585 NY Part B Supplier - Clinic/Group Practice 2466419718 Receives reassigned benefits from 24 practitioners
Practice locations: Utica, NY; Rochester, NY; New York, NY; New Hartford, NY; Ilion, NY
O20200727003232 CA Part B Supplier - Clinic/Group Practice 2466419718 Receives reassigned benefits from 2 practitioners
Practice locations: San Diego, CA; Santa Rosa, CA
O20200727003299 AZ Part B Supplier - Clinic/Group Practice 2466419718 Receives reassigned benefits from 1 practitioner
Practice locations: Scottsdale, AZ
O20201207000043 PA Part B Supplier - Clinic/Group Practice 2466419718 Receives reassigned benefits from 1 practitioner
Practice locations: Allentown, PA
O20230314003248 FL Part B Supplier - Clinic/Group Practice 2466419718 Receives reassigned benefits from 2 practitioners
Practice locations: Lake Mary, FL; Naples, FL
O20240726003381 TX Part B Supplier - Clinic/Group Practice 2466419718 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Locations

107 Business Park Dr
Utica, NY 13502
Phone (315) 792-4666

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X Primary

Addresses

NPPES NPI Registry

Primary practice location

107 Business Park Dr
Utica, NY 13502-6303

Mailing address

PO Box 625
New Hartford, NY 13413-0625
Phone (315) 798-1893

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
01647929MedicaidNY

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 9, 2020.

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594252800000",
    "number": "1790701167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 625",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134130625",
            "telephone_number": "315-798-1893",
            "fax_number": "315-724-3207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 BUSINESS PARK DR",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135026303",
            "telephone_number": "315-792-4666",
            "fax_number": "315-792-9698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMI PROFESSIONAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A",
        "authorized_official_last_name": "FOSSACECA",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "315-792-4666",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RT R MR"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01647929",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.