NPIMap

Tellica Imaging LLC

A Medicare group practice based in Salt Lake City, UT: 9 NPIs enrolled under one PECOS associate control ID (PAC ID 3577950765), with 128 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
3577950765The PECOS associate control ID: one enrolled organization, which may hold several NPIs
Provider type
Part B Supplier - Clinic/Group Practice, Part B Supplier - Independent Diagnostic Testing Facility (Idtf)
Enrolled in
ID, NH, UT
Enrollments
10
Group size
17 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
12In 11 places

Enrollment records 10

Enrollment IDStateProvider typeNPI
O20220418000658 UT Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 1407438039
O20220418001024 UT Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 1144802802
O20220516000636 UT Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 1508448291
O20240729002071 NH Part B Supplier - Clinic/Group Practice 1003510322
O20230614003649 UT Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 1649998709
O20230405001699 UT Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 1710605696
O20230508000797 UT Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 1205554367
O20231201000761 UT Part B Supplier - Clinic/Group Practice 1760197198
O20231209000226 ID Part B Supplier - Clinic/Group Practice 1760197198
O20250228000987 UT Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 1518727734

NPIs in this group 9

NPPES NPI Registry

These NPI records belong to the same enrolled organization. Each has its own page.

Practice locations

Locations on the Medicare enrollment

Clinicians 128

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Clinicians who reassign their Medicare benefits to this group (128) or whom Care Compare lists as members (17).

Sources for this page