NPIMap

Organization Active NPI

Meadows Nuclear Spect Imaging, PC

  • Nuclear Cardiology Physician
  • Smithtown, NY
National Provider Identifier
1962573592
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Cardiology PhysicianTaxonomy code 207UN0901X
Legal business name
MEADOWS NUCLEAR SPECT IMAGING, PC
Practice address
496 Smithtown Byp
Suite 206
Smithtown, NY 11787-5005
Phone
(631) 979-1699
Fax
(631) 979-1667
NPI assigned
Nov 13, 2006
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
Jacqueline Mayer
Title
VP, Managed Care & Credentialing
Phone
(631) 952-5717

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Cardiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207UN0901X Primary

Addresses

Primary practice location

496 Smithtown Byp
Suite 206
Smithtown, NY 11787-5005

Mailing address

PO Box 13116
Hauppauge, NY 11788-0556
Phone (631) 979-1699

Other identifiers 1

IdentifierTypeStateIssuer
02082653MedicaidNY

National Provider Directory

National Provider Directory

Locations

496 Smithtown Byp
Ste 206
Smithtown, NY 11787
Phone (631) 979-1699

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962573592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13116",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117880556",
            "telephone_number": "631-979-1699",
            "fax_number": "631-979-1667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 SMITHTOWN BYP",
            "address_2": "SUITE 206",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875005",
            "telephone_number": "631-979-1699",
            "fax_number": "631-979-1667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEADOWS NUCLEAR SPECT IMAGING, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAYER",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "VP, MANAGED CARE & CREDENTIALING",
        "authorized_official_telephone_number": "631-952-5717"
    },
    "taxonomies": [
        {
            "code": "207UN0901X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02082653",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, 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.