Organization Active NPI

Medical Diagnostic Inc.

  • Diagnostic Radiology Physician
  • Brooklyn, NY
National Provider Identifier
1881249035
Registry record updated Aug 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
MEDICAL DIAGNOSTIC INC.
Practice address
306 Bay 14TH St
Brooklyn, NY 11214-5810
Phone
(917) 348-3359
NPI assigned
Aug 5, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2019

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

Authorized official

Name
Yelena Liderman
Title
Owner
Phone
(917) 348-3359

Specialties & licenses 1

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

Addresses

Primary practice location

306 Bay 14TH St
Brooklyn, NY 11214-5810

Mailing address

306 Bay 14TH St
Brooklyn, NY 11214-5810

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191024002285 NY Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 7113259169 Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1564963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565222400000",
    "number": "1881249035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 BAY 14TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112145810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 BAY 14TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112145810",
            "telephone_number": "917-348-3359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL DIAGNOSTIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-05",
        "last_updated": "2019-08-08",
        "status": "A",
        "authorized_official_last_name": "LIDERMAN",
        "authorized_official_first_name": "YELENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-348-3359"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2019; 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.