NPIMap

Organization Active NPI

Medical Imaging of Fredericksburg, LLC

Doing business as Imaging Center for Women at North Stafford

  • Radiology Clinic/Center
  • Fredericksburg, VA
National Provider Identifier
1013950112
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
MEDICAL IMAGING OF FREDERICKSBURG, LLC
Doing business as
Imaging Center for Women at North Stafford
Medical Imaging of Embrey Mill
Medical Imaging of Fredericksburg1 more in Other names
Practice address
1201 Sam Perry Blvd Ste 102
Fredericksburg, VA 22401-4490
Phone
(540) 741-7025
NPI assigned
Jun 14, 2006
Last updated
Mar 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Authorized official

Name
Roni Faisal Talukdar, MDNPI 1134260540
Title
Mif President
Phone
(540) 361-1000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

1201 Sam Perry Blvd Ste 102
Fredericksburg, VA 22401-4490

Mailing address

PO Box 830008
Philadelphia, PA 19182-0008
Phone (540) 741-7025

Other practice location 1

125 Woodstream Blvd Ste 101
Stafford, VA 22556-4630
Phone (540) 657-9729

Other practice location 2

955D Wonder Rd
Stafford, VA 22554-7798
Phone (540) 741-7894

Other practice location 3

5501 Plank Road
Suite 101
Fredericksburg, VA 22407
Phone (540) 741-3189

Other identifiers 4

IdentifierTypeStateIssuer
=========OtherVATRICARE
317546OtherVAMAMSI
292008OtherVAANTHEM
3165OtherVACAREFIRST

Other names 4

  • Imaging Center for Women at North Stafford Doing business as
  • Medical Imaging of Embrey Mill Doing business as
  • Medical Imaging of Fredericksburg Doing business as
  • Medical Imaging of Harrison Crossing Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040618000469 VA Part B Supplier - Clinic/Group Practice 8426033135 Receives reassigned benefits from 55 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fredericksburg, VA; King George, VA; Stafford, VA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D1091309Medical Imaging of Fredericksburg1201 Sam Perry Boulevard - Suite 102, Fredericksburg, VA 22401Certificate of waiverOct 28, 2026

National Provider Directory

National Provider Directory
Tax ID family
Imaging Center for Women4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10401 Spotsylvania Ave
Ste 101
Fredericksburg, VA 22408
Phone (540) 741-7720

5501 Plank Rd
Ste 101
Fredericksburg, VA 22407
Phone (540) 741-3189

955 Wonder Rd
#D
Stafford, VA 22554
Phone (540) 741-7894

Practitioners & affiliated clinicians

Practitioners 32

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.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709769600000",
    "number": "1013950112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 830008",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191820008",
            "telephone_number": "540-741-7025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 SAM PERRY BLVD STE 102",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014490",
            "telephone_number": "540-741-7025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Woodstream Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Stafford",
            "state": "VA",
            "postal_code": "225564630",
            "country_code": "US",
            "telephone_number": "540-657-9729",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "955D Wonder Rd",
            "address_purpose": "LOCATION",
            "city": "Stafford",
            "state": "VA",
            "postal_code": "225547798",
            "country_code": "US",
            "telephone_number": "540-741-7894",
            "fax_number": "302-485-5373",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5501 Plank Road",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Fredericksburg",
            "state": "VA",
            "postal_code": "22407",
            "country_code": "US",
            "telephone_number": "540-741-3189",
            "fax_number": "540-741-9772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEDICAL IMAGING OF FREDERICKSBURG, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A",
        "authorized_official_last_name": "TALUKDAR",
        "authorized_official_first_name": "RONI",
        "authorized_official_middle_name": "FAISAL",
        "authorized_official_title_or_position": "MIF PRESIDENT",
        "authorized_official_telephone_number": "540-361-1000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "=========",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "317546",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "292008",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "3165",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Imaging Center for Women at North Stafford",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medical Imaging of Embrey Mill",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medical Imaging of Fredericksburg",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medical Imaging of Fredericksburg",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medical Imaging of Harrison Crossing",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.