Organization Active NPI

Sra Medical Imaging LLC

  • Diagnostic Radiology Physician
  • Buffalo, NY
National Provider Identifier
1881920452
Registry record updated May 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
SRA MEDICAL IMAGING LLC
Practice address
2157 Main St
Buffalo, NY 14214-2648
Phone
(716) 862-1000
NPI assigned
Nov 2, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2019

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

Authorized official

Name
Edie Haier
Title
Billing Manager
Phone
(316) 650-9030

Specialties & licenses 1

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

Addresses

Primary practice location

2157 Main St
Buffalo, NY 14214-2648

Mailing address

PO Box 247
Albany, NY 12201-0247
Phone (316) 650-9030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL, ME, VT, VA, WV, CO, CA, AZ, DC, TX, PA, IL, PR, WI, HI, NJ, CT, MA, NC20 enrollments

Enrollment records 20

Enrollment IDStateProvider typePAC IDDetails
O20040708000623 NY Part B Supplier - Clinic/Group Practice 1759369663 Receives reassigned benefits from 27 practitioners
Practice locations: Newburgh, NY; Niagara Falls, NY; Old Westbury, NY; Orchard Park, NY; Plattsburgh, NY; Rochester, NY; Sag Harbor, NY; Salt Point, NY…
O20190403003005 FL Part B Supplier - Clinic/Group Practice 1759369663 Receives reassigned benefits from 9 practitioners
Practice locations: Parkland, FL; Miami, FL; Lakewood Ranch, FL; Jacksonville, FL; Boca Raton, FL; Hallandale Beach, FL; Gainesville, FL
O20220406000176 ME Part B Supplier - Clinic/Group Practice 1759369663 Receives reassigned benefits from 1 practitioner
Practice locations: Portland, ME
O20220825000238 VT Part B Supplier - Clinic/Group Practice 1759369663 Practice locations: South Hero, VT
O20230901001938 VA Part B Supplier - Clinic/Group Practice 1759369663 Receives reassigned benefits from 2 practitioners
Practice locations: Bristol, VA; Williamsburg, VA
O20230915003521 WV Part B Supplier - Clinic/Group Practice 1759369663 Receives reassigned benefits from 1 practitioner
Practice locations: Huntington, WV
O20230926002770 CO Part B Supplier - Clinic/Group Practice 1759369663 Receives reassigned benefits from 1 practitioner
Practice locations: Monument, CO
O20231009001983 CA Part B Supplier - Clinic/Group Practice 1759369663 Receives reassigned benefits from 5 practitioners
Practice locations: Fresno, CA; Irvine, CA; Los Angeles, CA; Rancho Cucamonga, CA; Santa Monica, CA
O20240410002450 AZ Part B Supplier - Clinic/Group Practice 1759369663 Receives reassigned benefits from 1 practitioner
Practice locations: Scottsdale, AZ
O20240410003304 DC Part B Supplier - Clinic/Group Practice 1759369663 Receives reassigned benefits from 5 practitioners
Practice locations: Washington, DC; Silver Spring, MD
O20240424001308 TX Part B Supplier - Clinic/Group Practice 1759369663 Receives reassigned benefits from 4 practitioners
Practice locations: Sugar Land, TX; Houston, TX; Fort Worth, TX; Austin, TX
O20240528000353 PA Part B Supplier - Clinic/Group Practice 1759369663 Receives reassigned benefits from 1 practitioner
Practice locations: Pittsburgh, PA
O20240702001460 IL Part B Supplier - Clinic/Group Practice 1759369663 Receives reassigned benefits from 5 practitioners
Practice locations: Woodridge, IL; Peoria, IL; Oak Brook, IL; Naperville, IL; Lisle, IL
O20241202002213 PR Part B Supplier - Clinic/Group Practice 1759369663 Receives reassigned benefits from 1 practitioner
Practice locations: San Juan, PR
O20241210003091 WI Part B Supplier - Clinic/Group Practice 1759369663 Receives reassigned benefits from 1 practitioner
Practice locations: Madison, WI
O20250106000771 HI Part B Supplier - Clinic/Group Practice 1759369663 Receives reassigned benefits from 1 practitioner
Practice locations: Honolulu, HI
O20250204003175 NJ Part B Supplier - Clinic/Group Practice 1759369663 Receives reassigned benefits from 2 practitioners
Practice locations: Jersey City, NJ; Princeton, NJ
O20250210000205 CT Part B Supplier - Clinic/Group Practice 1759369663 Receives reassigned benefits from 1 practitioner
Practice locations: East Lyme, CT
O20250910003485 MA Part B Supplier - Clinic/Group Practice 1759369663 Receives reassigned benefits from 1 practitioner
Practice locations: Somerville, MA
O20260105001704 NC Part B Supplier - Clinic/Group Practice 1759369663 Receives reassigned benefits from 1 practitioner
Practice locations: Raleigh, NC

National Provider Directory

National Provider Directory

Locations

3972 Barranca Pkwy
#J408
Irvine, CA 92606

2914 Elmwood Ave
Kenmore, NY 14217
Phone (716) 447-6310

27 Frost Ln
Lawrence, NY 11559
Phone (516) 295-1176

6932 Williams Rd
Niagara Falls, NY 14304
Phone (716) 298-1635

Practitioners & affiliated clinicians

Practitioners 79

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

View all 79

NPI Registry JSON

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

{
    "created_epoch": "1257120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558483200000",
    "number": "1881920452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 247",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122010247",
            "telephone_number": "316-650-9030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2157 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142142648",
            "telephone_number": "716-862-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRA MEDICAL IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-02",
        "last_updated": "2019-05-22",
        "status": "A",
        "authorized_official_last_name": "HAIER",
        "authorized_official_first_name": "EDIE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "316-650-9030"
    },
    "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 Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.