NPIMap

Organization Active NPI

Union Square Medical Imaging and Mammography PC

  • Mammography Clinic/Center
  • New York, NY
National Provider Identifier
1912037102
Registry record updated Oct 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mammography Clinic/CenterTaxonomy code 261QR0206X
License
200740-1 Issued in NY
Legal business name
UNION SQUARE MEDICAL IMAGING AND MAMMOGRAPHY PC
Practice address
200 Park Ave S
Suite 1103
New York, NY 10003-1503
Phone
(212) 674-0444
Fax
(212) 477-4163
NPI assigned
Mar 6, 2007
Last updated
Oct 27, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2016

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

Authorized official

Name
Dr. Terrance Lee, MDNPI 1053350389
Title
Medical Director
Phone
(212) 674-0444

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
Mammography Clinic/Center 261QR0206X 200740-1 NY Primary

Addresses

Primary practice location

200 Park Ave S
Suite 1103
New York, NY 10003-1503

Mailing address

200 Park Ave S
Suite 1103
New York, NY 10003-1503
Phone (212) 674-0444

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050316000779 NY Part B Supplier - Clinic/Group Practice 1153376744 Receives reassigned benefits from 12 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

200 Park Ave S
Ste 1103
New York, NY 10003
Phone (212) 674-0444

Practitioners & affiliated clinicians

Practitioners 47

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477526400000",
    "number": "1912037102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PARK AVE S",
            "address_2": "SUITE 1103",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100031503",
            "telephone_number": "212-674-0444",
            "fax_number": "212-477-4163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PARK AVE S",
            "address_2": "SUITE 1103",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100031503",
            "telephone_number": "212-674-0444",
            "fax_number": "212-477-4163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNION SQUARE MEDICAL IMAGING AND MAMMOGRAPHY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2016-10-27",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "TERRANCE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "212-674-0444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": "NY",
            "license": "200740-1",
            "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 Oct 27, 2016; 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.