Organization Active NPI

Lakes Radiology PLLC

  • Diagnostic Radiology Physician
  • Auburn, NY
National Provider Identifier
1962642694
Registry record updated Apr 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
LAKES RADIOLOGY PLLC
Practice address
1626 Clark Street Road
Suite 18
Auburn, NY 13021
Phone
(315) 252-9462
Fax
(315) 252-9466
NPI assigned
Feb 20, 2009
Organization subpart
Yes
Parent organization
LAKES RADIOLOGY PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 12, 2011

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

Authorized official

Name
Mr. Craig Foster, MD
Title
Owner
Phone
(585) 944-1665

Specialties & licenses 1

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

Addresses

Primary practice location

1626 Clark Street Road
Suite 18
Auburn, NY 13021

Mailing address

1626 Clark Street Road
Suite 18
Auburn, NY 13021
Phone (315) 252-9462

Other names 1

  • Central Auburn Imaging LLC Doing business as

National Provider Directory

National Provider Directory
Part of
Lakes Radiology PLLC

Locations

1626 Clark Street Rd
Ste 18
Auburn, NY 13021
Phone (315) 252-9462

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1235088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302566400000",
    "number": "1962642694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 CLARK STREET ROAD",
            "address_2": "SUITE 18",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "13021",
            "telephone_number": "315-252-9462",
            "fax_number": "315-252-9466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 CLARK STREET ROAD",
            "address_2": "SUITE 18",
            "city": "AUBURN",
            "state": "NY",
            "postal_code": "13021",
            "telephone_number": "315-252-9462",
            "fax_number": "315-252-9466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKES RADIOLOGY PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAKES RADIOLOGY PLLC",
        "enumeration_date": "2009-02-20",
        "last_updated": "2011-04-12",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "585-944-1665",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Auburn Imaging LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Auburn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2011; 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.