NPIMap

Organization Active NPI

Damadian MRI in Canarsie, P.C.

  • Diagnostic Radiology Physician
  • Brooklyn, NY
National Provider Identifier
1962593061
Registry record updated Jun 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
DAMADIAN MRI IN CANARSIE, P.C.
Practice address
2035 Ralph Ave
Suite a-5
Brooklyn, NY 11234-5300
Phone
(718) 209-1070
Fax
(718) 209-1138
NPI assigned
Sep 27, 2006
Last updated
Jun 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2012

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

Authorized official

Name
Stephen Marc Hershowitz, M.D.NPI 1619970084
Title
Owner
Phone
(631) 396-1050

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
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

2035 Ralph Ave
Suite a-5
Brooklyn, NY 11234-5300

Mailing address

PO Box 170
Farmingdale, NY 11735-0170
Phone (631) 396-1050

Other identifiers 1

IdentifierTypeStateIssuer
02866695MedicaidNY

Other names 1

  • Canarsie MRI, P.C. Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040323000173 NY Part B Supplier - Clinic/Group Practice 3577454255 Receives reassigned benefits from 20 practitioners
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

2035 Ralph Ave
Ste A5
Brooklyn, NY 11234
Phone (718) 209-1070

Practitioners & affiliated clinicians

Practitioners 26

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 26

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339977600000",
    "number": "1962593061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 170",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117350170",
            "telephone_number": "631-396-1050",
            "fax_number": "631-396-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 RALPH AVE",
            "address_2": "SUITE A-5",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112345300",
            "telephone_number": "718-209-1070",
            "fax_number": "718-209-1138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAMADIAN MRI IN CANARSIE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2012-06-18",
        "status": "A",
        "authorized_official_last_name": "HERSHOWITZ",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "MARC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-396-1050",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02866695",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canarsie MRI, P.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2012; 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.