NPIMap

Organization Active NPI

Williston Radiology Consultants PC

Doing business as Fairlight Medical Center

  • Specialist
  • Williston, ND
National Provider Identifier
1942375852
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
7782 Issued in ND
Legal business name
WILLISTON RADIOLOGY CONSULTANTS PC
Doing business as
Fairlight Medical Center
Practice address
3 4TH St E
Suite 201
Williston, ND 58801-5350
Phone
(701) 577-4867
NPI assigned
Nov 24, 2006
Last updated
Mar 13, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

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

Authorized official

Name
Dr. Leszek J Jaszczak, M.D.NPI 1467528455
Title
President
Phone
(701) 577-6337

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
Specialist 174400000X 7782 ND Primary

Addresses

Primary practice location

3 4TH St E
Suite 201
Williston, ND 58801-5350

Mailing address

PO Box 1148
Williston, ND 58802-1148
Phone (701) 577-4867

Other names 1

  • Fairlight Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041005001169 ND Part B Supplier - Clinic/Group Practice 2365334828 Receives reassigned benefits from 7 practitioners
1 other NPI on this enrollment
Practice locations: Williston, ND

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

3 4th St E
Apt 201
Williston, ND 58801
Phone (701) 577-4867

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584057600000",
    "number": "1942375852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1148",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588021148",
            "telephone_number": "701-577-4867",
            "fax_number": "701-577-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 4TH ST E",
            "address_2": "SUITE 201",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588015350",
            "telephone_number": "701-577-4867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLISTON RADIOLOGY CONSULTANTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A",
        "authorized_official_last_name": "JASZCZAK",
        "authorized_official_first_name": "LESZEK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-577-6337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "ND",
            "license": "7782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fairlight Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williston, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.