NPIMap

Organization Active NPI

Goethals Radiology PC

  • Diagnostic Radiology Physician
  • Staten Island, NY
National Provider Identifier
1962492546
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
6050006 Issued in NY
Legal business name
GOETHALS RADIOLOGY PC
Practice address
475 Seaview Ave
Staten Island, NY 10305-3436
Phone
(718) 226-9175
Fax
(718) 876-3462
NPI assigned
Oct 25, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Shalom Buchbinder, MD
Title
President
Phone
(718) 226-9175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X 6050006 NY Primary

Addresses

Primary practice location

475 Seaview Ave
Staten Island, NY 10305-3436

Mailing address

PO Box 4652
Warren, NJ 07059-0652
Phone (718) 226-9175

Other identifiers 6

IdentifierTypeStateIssuer
3217156OtherAETNA
3C3756OtherHEALTHNET
02597262MedicaidNY
WTE361OtherEMPIRE BC/BS
2318846OtherUHC
4105246OtherGHI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 46

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

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962492546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4652",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "070590652",
            "telephone_number": "718-226-9175",
            "fax_number": "718-876-3462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053436",
            "telephone_number": "718-226-9175",
            "fax_number": "718-876-3462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOETHALS RADIOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BUCHBINDER",
        "authorized_official_first_name": "SHALOM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-226-9175",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "6050006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3217156",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "3C3756",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02597262",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC/BS",
            "identifier": "WTE361",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "2318846",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "4105246",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.