Active NPI
Joan A Kedziora, M.D.
- Diagnostic Radiology Physician
- New York, NY
National Provider Identifier
1831139153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 106709-1
- Practice address
- 155 Canal St
New York, NY 10013-4511 - Phone
- (212) 219-9135
- Fax
- (212) 219-9291
- NPI assigned
- Jun 7, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 106709-1 | NY | Primary |
Addresses
Primary practice location
155 Canal St
New York, NY 10013-4511
Mailing address
155 Canal St
New York, NY 10013-4511
Phone (212) 219-9135
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 106709-1 | NY | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CP Advanced Imaging PLLC | Diagnostic Radiology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Diagnostic Radiology Physician
- New York, NY
- NPI 1790736551
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1831139153",
"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": "100134511",
"telephone_number": "212-219-9135",
"fax_number": "212-219-9291"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEDZIORA",
"first_name": "JOAN",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NY",
"license": "106709-1",
"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 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.