NPIMap

Individual provider Active NPI

Susan Krysiewicz, M.D

  • Radiological Physics Physician
  • New York, NY
National Provider Identifier
1821034935
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiological Physics PhysicianTaxonomy code 2085R0205X
License
154697 Issued in NY
Practice address
First Avenue and 16TH Steet
New York, NY 10003
Phone
(212) 844-8880
Fax
(212) 590-2982
NPI assigned
Jun 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiological Physics Physician 2085R0205X 154697 NY Primary

Addresses

Primary practice location

First Avenue and 16TH Steet
New York, NY 10003

Mailing address

1780 Broadway
Suite 1100
New York, NY 10019
Phone (212) 590-2930

Other identifiers 1

IdentifierTypeStateIssuer
01149980MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
East Manhattan Diagnostic Imaging, PC Past Accepting new patients
East Manhattan Diagnostic Imaging, P.C. Past Accepting new patients
SLR Diagnostic Radiology, P.C. Radiological Physics Past Accepting new patients
West Side Radiology Associates, PC Radiological Physics Past Accepting new patients
Bimc Faculty Practice Past Accepting new patients
SLR Diagnostic Radiology, P.C. Past Accepting new patients
Beth Israel Medical Center Radiological Physics Past Accepting new patients

Organizations & group practices 7

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821034935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1780 BROADWAY",
            "address_2": "SUITE 1100",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10019",
            "telephone_number": "212-590-2930",
            "fax_number": "212-590-2982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FIRST AVENUE AND 16TH STEET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10003",
            "telephone_number": "212-844-8880",
            "fax_number": "212-590-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRYSIEWICZ",
        "first_name": "SUSAN",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0205X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiological Physics",
            "state": "NY",
            "license": "154697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01149980",
            "state": "NY"
        }
    ],
    "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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.