NPIMap

Organization Active NPI

CP Advanced Imaging PLLC

  • Diagnostic Radiology Physician
  • New York, NY
National Provider Identifier
1790736551
Registry record updated Aug 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
104217-1 Issued in NY
Legal business name
CP ADVANCED IMAGING PLLC
Practice address
155 Canal St
New York, NY 10013-4551
Phone
(212) 431-9010
Fax
(212) 219-9291
NPI assigned
May 15, 2006
Last updated
Aug 19, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2015

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

Authorized official

Name
Dr. James Chang, M.D.NPI 1952355737
Title
President
Phone
(212) 219-9135

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X 104217-1 NY Primary

Addresses

Primary practice location

155 Canal St
New York, NY 10013-4551

Mailing address

155 Canal St
New York, NY 10013-4511
Phone (212) 219-9135

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051116001031 NY Part B Supplier - Clinic/Group Practice 4385663582 Receives reassigned benefits from 14 practitioners
Practice locations: Brooklyn, NY; Woodbury, NY; Pomona, NY; New York, NY; Great Neck, NY

National Provider Directory

National Provider Directory

Locations

5521 8th Ave
Brooklyn, NY 11220

155 Canal St
New York, NY 10013
Phone (212) 219-9135

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439942400000",
    "number": "1790736551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 CANAL ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134511",
            "telephone_number": "212-219-9135",
            "fax_number": "212-219-9291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 CANAL ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134551",
            "telephone_number": "212-431-9010",
            "fax_number": "212-219-9291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CP ADVANCED IMAGING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2015-08-19",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-219-9135",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "104217-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; 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.