Imaging Professionals of Pennsylvania PC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

IMAGING PROFESSIONALS OF PENNSYLVANIA PC

Doing business as

Northeast Imaging

Practice address

8001 Roosevelt Blvd
Philadelphia, PA 19152-3038

Phone

(888) 440-6494

Fax

(330) 759-1501

NPI assigned

Aug 29, 2005

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

IMAGING PROFESSIONALS OF PENNSYLVANIA PCAs reported in NPPES

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

Authorized official

Name

David L Bloom, MD

Title

President

Phone

(973) 707-1100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Northeast Imaging Doing business as

Part of

Imaging Profs of PA PC

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1023001690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 SPRING HILL RD",
            "address_2": "SUITE 500",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023000",
            "telephone_number": "973-707-1100",
            "fax_number": "973-707-1127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191523038",
            "telephone_number": "888-440-6494",
            "fax_number": "330-759-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGING PROFESSIONALS OF PENNSYLVANIA PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IMAGING PROFESSIONALS OF PENNSYLVANIA PC",
        "enumeration_date": "2005-08-29",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BLOOM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-707-1100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011008510016",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northeast Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Diagnostic Radiology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Diagnostic Radiology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.