Overlake Breast Imaging LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

OVERLAKE BREAST IMAGING LLC

Doing business as

Overlake Breast MRI

Practice address

1135 116TH Ave NE
Suite 255
Bellevue, WA 98004

Phone

(425) 467-3754

Fax

(425) 213-1336

NPI assigned

Nov 6, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark P Jones

Title

Co-Manager

Phone

(425) 771-8161

Specialties & licenses 1

Addresses

Other names 1

• Overlake Breast MRI Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marita Barbara Acheson, M.D.

  • Diagnostic Radiology Physician
  • Bellevue, WA
  • NPI 1528087582
  NPD (past)
• David Lee Magaram, M.D.

  • Diagnostic Radiology Physician
  • Seattle, WA
  • NPI 1962451674
  NPD (past)
• Meredith Roe-Ranzenbach Watts, M.D.

  • Diagnostic Radiology Physician
  • Hershey, PA
  • NPI 1922032531
  NPD (past)

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003985060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19401 40TH AVE WEST",
            "address_2": "SUITE 140",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364612",
            "telephone_number": "425-771-8161",
            "fax_number": "425-771-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 116TH AVE NE",
            "address_2": "SUITE 255",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98004",
            "telephone_number": "425-467-3754",
            "fax_number": "425-213-1336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OVERLAKE BREAST IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CO-MANAGER",
        "authorized_official_telephone_number": "425-771-8161"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Overlake Breast MRI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Over Lake Medical Center
• Linda Overbay, PT
• Overlake Ambulatory Surgery Center, LLC (Overlake Surgery Center LLC)
• Overlake Arthritis and Osteoporosis Center, PLLC
• Overlake Arthritis and Osteoporosis Center, PLLC
• Overlake Colon & Rectal Clinic, PLLC
• Overlake Eyecare P S
• Overlake Family Dental (Bellevue Overlake Dental)
• Overlake Family Vision, PLLC
• Overlake Hospital Medical Center

• Radiology Clinic/Center in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Radiology Clinic/Center in Washington

• 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.