Juniper Radiology, PC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

JUNIPER RADIOLOGY, PC

Practice address

224 E Main St
Springville, NY 14141-1443

Phone

(716) 592-2871

NPI assigned

Apr 4, 2007

Organization subpart

No

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

Authorized official

Name

Mark Fenzl, MDNPI 1710958780

Title

President

Phone

(716) 649-1722

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

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

• Mark Fenzl, MD

  • Diagnostic Radiology Physician
  • Springville, NY
  • NPI 1710958780
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587600000000",
    "number": "1992827729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1314",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141278314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 E MAIN ST",
            "city": "SPRINGVILLE",
            "state": "NY",
            "postal_code": "141411443",
            "telephone_number": "716-592-2871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUNIPER RADIOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A",
        "authorized_official_last_name": "FENZL",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "716-649-1722",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS WESTERN NY",
            "identifier": "GRP529117001",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02872008",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Jackson, SLP
• Jane D. Kraft, MD, PLLC
• Jennie B. Richmond Chaffee Nursing Home Company
• JSSG Healthcare LLC.
• Jessica Judware
• Alicia Kaufman, LMSW
• Nicole Kaus
• Sherilyn Kehr
• Tanya Kelly, LMHC
• Pamela Suzanne Kendall, MS CCC/SLP

• Diagnostic Radiology Physician in Springville, NY
• Providers in Springville, NY by specialty
• Diagnostic Radiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2020; 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.