Organization Active NPI

Tristan Associates

Doing business as Susquehanna Valley Imaging

  • Diagnostic Radiology Physician
  • Lewisburg, PA
National Provider Identifier
1972589075
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
TRISTAN ASSOCIATES
Doing business as
Susquehanna Valley Imaging
Practice address
28 Silvermoon LN
Lewisburg, PA 17837-6354
Phone
(570) 522-9300
Fax
(570) 522-9304
NPI assigned
Dec 20, 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
Mr. Paul Deloia Jr.
Title
Ceo Tristan Associates
Phone
(717) 652-6105

Specialties & licenses 1

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

Addresses

Primary practice location

28 Silvermoon LN
Lewisburg, PA 17837-6354

Mailing address

4520 Union Deposit Rd
Harrisburg, PA 17111-2910
Phone (717) 652-6105

Other identifiers 1

IdentifierTypeStateIssuer
0671945MedicaidPA

Other names 1

  • Susquehanna Valley Imaging Doing business as

National Provider Directory

National Provider Directory

Locations

28 Silvermoon Ln
Lewisburg, PA 17837
Phone (570) 522-9300

NPI Registry JSON

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972589075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4520 UNION DEPOSIT RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171112910",
            "telephone_number": "717-652-6105",
            "fax_number": "717-652-2165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 SILVERMOON LN",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178376354",
            "telephone_number": "570-522-9300",
            "fax_number": "570-522-9304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRISTAN ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DELOIA",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO TRISTAN ASSOCIATES",
        "authorized_official_telephone_number": "717-652-6105",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "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": "0671945",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Susquehanna Valley Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lewisburg, PA

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.