NPIMap

Organization Active NPI

Stand-Up MRI of Deer Park, P.C.

  • Diagnostic Radiology Physician
  • North Babylon, NY
National Provider Identifier
1821180159
Registry record updated Jul 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
STAND-UP MRI OF DEER PARK, P.C.
Practice address
1118 Deer Park Ave
North Babylon, NY 11703-3102
Phone
(631) 243-3222
Fax
(631) 243-3355
NPI assigned
Sep 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2012

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

Authorized official

Name
Stephen M Hershowitz, M.D.NPI 1619970084
Title
Owner
Phone
(631) 396-1050

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 Primary

Addresses

Primary practice location

1118 Deer Park Ave
North Babylon, NY 11703-3102

Mailing address

PO Box 170
Farmingdale, NY 11735-0170
Phone (631) 396-1050

Other identifiers 1

IdentifierTypeStateIssuer
02864868MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040218000753 NY Part B Supplier - Clinic/Group Practice 2163317157 Receives reassigned benefits from 21 practitioners
Practice locations: North Babylon, NY

National Provider Directory

National Provider Directory

Locations

1118 Deer Park Ave
North Babylon, NY 11703
Phone (631) 243-3222

Practitioners & affiliated clinicians

Practitioners 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342137600000",
    "number": "1821180159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 170",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117350170",
            "telephone_number": "631-396-1050",
            "fax_number": "631-396-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 DEER PARK AVE",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "117033102",
            "telephone_number": "631-243-3222",
            "fax_number": "631-243-3355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAND-UP MRI OF DEER PARK, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2012-07-13",
        "status": "A",
        "authorized_official_last_name": "HERSHOWITZ",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-396-1050",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02864868",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Babylon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2012; 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.