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MOHAWK GLEN RADIOLOGY ASSOCIATES OF CNY PLLC
NPI 1538466115
Radiology - Diagnostic Radiology in Rome, NY

Active since February 17, 2011
91 PERIMETER RD, SUITE 110, ROME, NY 13441(315) 334-9729(315) 334-1185 Get Directions Write a Review

NPPES record last updated: March 4, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 4, 2019, Jan 28, 2019 (2 updates tracked since 2019).

About Mohawk Glen Radiology Associates Of Cny Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOHAWK GLEN RADIOLOGY ASSOCIATES OF CNY PLLC (NPI 1538466115) is a healthcare organization registered as a diagnostic radiology in Rome, New York and active in the NPI registry since February 2011. The organization lists Philip J Fraccola, Authorized Signer, as its authorized official.

NPPES Registry Identity

NPI1538466115
Entity TypeOrganization
Primary Taxonomy2085R0202X
Legal Business NameMOHAWK GLEN RADIOLOGY ASSOCIATES OF CNY PLLC
Location Address91 PERIMETER RD, SUITE 110Rome, NY 13441-4018
Mailing AddressPo Box 394Canajoharie, NY 13317-0394 · (315) 339-7965 · Fax (814) 235-1566
Phone(315) 334-9729
Fax(315) 334-1185
Organization SubpartNo
Authorized OfficialPhilip J FraccolaAuthorized Signer · (315) 382-3031
Enumeration DateFebruary 17, 2011
Last NPPES UpdateMarch 4, 20192 updates tracked since enumeration
✔ NPI 1538466115 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
91 PERIMETER RD, Rome, NY 13441
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Other Identifiers 1

Medicaid03387708NY

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mohawk Glen Radiology Associates Of Cny Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

17

Medicare enrollment records show 17 clinicians reassign Medicare billing to Mohawk Glen Radiology Associates Of Cny PLLC, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians by Medicare Specialty 2

Diagnostic Radiology16
Nurse Practitioner1

Clinicians, nearest first (17)

Srinivas Paidy, M.D.
Diagnostic Radiology
NPI 1346459617
2209 GENESEE STREET
Utica, NY 13501
(315) 798-8171
✔ PECOS✔ Accepts Medicare11 mi
Nicole Noble, NP
Nurse Practitioner
NPI 1831232701
5008 BRITTONFIELD PKWY SUITE 700
East Syracuse, NY 13057
(315) 472-7504
✔ PECOS✔ Accepts Medicare34 mi
Lawrence Calabrese, M.D.
Diagnostic Radiology
NPI 1548252646
5100 W TAFT RD SUITE 2A
Liverpool, NY 13088
(315) 452-2555
✔ PECOS✔ Accepts Medicare39 mi
Sherwin Pollock, M.D.
Diagnostic Radiology
NPI 1164414066
5100 W TAFT RD SUITE 2A
Liverpool, NY 13088
(315) 452-2555
✔ PECOS✔ Accepts Medicare39 mi
Christopher Vaughn, MD
Diagnostic Radiology
NPI 1497728091
5100 W TAFT RD SUITE 2A
Liverpool, NY 13088
(315) 452-2555
✔ PECOS✔ Accepts Medicare39 mi
Shain Wallis, DO
Diagnostic Radiology
NPI 1356653729
5100 WEST TAFT RD STE 2A
Liverpool, NY 13088
(315) 452-2666
✔ PECOS✔ Accepts Medicare39 mi
Gary Leavitt, M.D.
Diagnostic Radiology
NPI 1053303040
5100 W TAFT RD SUITE 2A
Liverpool, NY 13088
(315) 452-2555
✔ PECOS✔ Accepts Medicare39 mi
Wilfred Carey, MD
Diagnostic Radiology
NPI 1235121336
5100 W TAFT RD SUITE 2A
Liverpool, NY 13088
(315) 452-2555
✔ PECOS✔ Accepts Medicare39 mi
Philip Fraccola, M.D.
Diagnostic Radiology
NPI 1699767707
5100 W TAFT RD SUITE 2A
Liverpool, NY 13088
(315) 452-2555
✔ PECOS✔ Accepts Medicare39 mi
John Teixeira, M.D.
Diagnostic Radiology
NPI 1124010038
5100 W TAFT RD SUITE 2A
Liverpool, NY 13088
(315) 452-2555
✔ PECOS✔ Accepts Medicare39 mi
Michael Rachun, MD
Diagnostic Radiology
NPI 1134656598
750 E ADAMS ST
Syracuse, NY 13210
(315) 464-5240
✔ PECOS✔ Accepts Medicare40 mi
Michael Chang, M.D.
Diagnostic Radiology
NPI 1457688731
104 UNION AVE STE 905
Syracuse, NY 13203
(315) 703-5017
✔ PECOS✔ Accepts Medicare40 mi
Mark Baesl, MD
Diagnostic Radiology
NPI 1750547386
301 PROSPECT AVE DEPT. OF RADIOLOGY
Syracuse, NY 13203
(315) 703-2138
✔ PECOS✔ Accepts Medicare40 mi
Juno Lee, M.D.
Diagnostic Radiology
NPI 1265424006
301 PROSPECT AVE
Syracuse, NY 13203
(315) 448-5416
✔ PECOS✔ Accepts Medicare40 mi
Thomas Marini, MD
Diagnostic Radiology
NPI 1194253864
601 ELMWOOD AVENUE BOX 648
Rochester, NY 14642
(585) 784-2985
✔ PECOS✔ Accepts Medicare113 mi
Rajan Murthy, MD
Diagnostic Radiology
NPI 1396770418
622 W 168TH ST
New York, NY 10032
(212) 305-9335
✔ PECOS179 mi
James Terzian, M.D.
Diagnostic Radiology
NPI 1609034388
901 N BROAD ST NE STE 120
Rome, GA 30161
(706) 291-2661
✔ PECOS✔ Accepts Medicare811 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mohawk Glen Radiology Associates Of Cny PLLC's NPI number?

The NPI number for Mohawk Glen Radiology Associates Of Cny PLLC is 1538466115. It was assigned to this organization in the NPPES registry on February 17, 2011.

Where is Mohawk Glen Radiology Associates Of Cny PLLC located?

Mohawk Glen Radiology Associates Of Cny PLLC is located at 91 Perimeter Rd Suite 110, Rome, NY 13441. The listed phone number is (315) 334-9729.

What is Mohawk Glen Radiology Associates Of Cny PLLC's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Mohawk Glen Radiology Associates Of Cny PLLC enrolled in Medicare?

Yes. Mohawk Glen Radiology Associates Of Cny PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mohawk Glen Radiology Associates Of Cny PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 17 clinicians in 2 Medicare specialties reassign their Medicare billing to Mohawk Glen Radiology Associates Of Cny PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Diagnostic Radiology (16) and Nurse Practitioner (1). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Mohawk Glen Radiology Associates Of Cny PLLC was last updated on March 4, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.