Mobile Diagnostic Testing Services Inc

Primary specialty

Diagnostic Ultrasound PhysicianTaxonomy code 2085U0001X

Legal business name

MOBILE DIAGNOSTIC TESTING SERVICES INC

Practice address

4950 Genesee St
Suite 180
Buffalo, NY 14225-5550

Phone

(716) 686-7100

Fax

(716) 614-3282

NPI assigned

Feb 26, 2007

Organization subpart

No

Name

Daniel T McDonnell

Title

Executive Vice President

Phone

(716) 686-7110

Locations

• HealthTrac Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 25, 2012.

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340582400000",
    "number": "1003942855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4950 GENESEE ST",
            "address_2": "SUITE 180",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142255550",
            "telephone_number": "716-686-7100",
            "fax_number": "716-614-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4950 GENESEE ST",
            "address_2": "SUITE 180",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142255550",
            "telephone_number": "716-686-7100",
            "fax_number": "716-614-3282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE DIAGNOSTIC TESTING SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2012-06-25",
        "status": "A",
        "authorized_official_last_name": "MCDONNELL",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "716-686-7110"
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHA",
            "identifier": "7602181",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS WNY",
            "identifier": "000510159003",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00020000502",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GOVT INS",
            "identifier": "0073926",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthTrac",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Peter Mittiga
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• Ause Mmbamba
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• Sandra Mobley-Terry, CASAC

• All providers in Buffalo, NY
• Diagnostic Ultrasound Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2012; 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.