NPIMap

Organization Active NPI

University Diagnostic Medical Imaging,PC

  • Diagnostic Radiology Physician
  • Bronx, NY
National Provider Identifier
1922032150
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
H90 1185210 83 NY Issued in NY
Legal business name
UNIVERSITY DIAGNOSTIC MEDICAL IMAGING,PC
Practice address
1200 Waters PL
Suite M-108
Bronx, NY 10461-2728
Phone
(718) 931-5620
Fax
(718) 824-0706
NPI assigned
Jul 11, 2006
Last updated
Aug 3, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Authorized official

Name
Dr. Marc Prager, MDNPI 1588695522
Title
Medical Director
Phone
(718) 931-7080

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 7

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X
Neuroradiology Physician 2085N0700X
Nuclear Radiology Physician 2085N0904X 91-3255-01 NY
Diagnostic Radiology Physician 2085R0202X H90 1185210 83 NY NY Primary
Therapeutic Radiology Physician 2085R0203X 91-3255-01 NY
Vascular & Interventional Radiology Physician 2085R0204X
Diagnostic Ultrasound Physician 2085U0001X

Addresses

Primary practice location

1200 Waters PL
Suite M-108
Bronx, NY 10461-2728

Mailing address

1200 Waters PL
Suite M-108
Bronx, NY 10461-2728
Phone (718) 931-5620

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040313000047 NY Part B Supplier - Clinic/Group Practice 8628967023 Receives reassigned benefits from 7 practitioners
Practice locations: Bronx, NY

National Provider Directory

National Provider Directory

Locations

1200 Waters Pl
Rm M108
Bronx, NY 10461
Phone (718) 931-2300

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596412800000",
    "number": "1922032150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 WATERS PL",
            "address_2": "SUITE M-108",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612728",
            "telephone_number": "718-931-5620",
            "fax_number": "718-824-0706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 WATERS PL",
            "address_2": "SUITE M-108",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612728",
            "telephone_number": "718-931-5620",
            "fax_number": "718-824-0706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY DIAGNOSTIC MEDICAL IMAGING,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A",
        "authorized_official_last_name": "PRAGER",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "718-931-7080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "NY",
            "license": "91-3255-01",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "H90 1185210 83 NY",
            "primary": true
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "NY",
            "license": "91-3255-01",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; 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.