NPIMap

Organization Active NPI

RPJ Liberty Enterprises LLC

Doing business as Liberty Open MRI

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Youngstown, OH
National Provider Identifier
1023466240
Registry record updated Jul 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
Legal business name
RPJ LIBERTY ENTERPRISES LLC
Doing business as
Liberty Open MRI
Practice address
4300 Belmont Ave
Suite #6
Youngstown, OH 44505-1084
Phone
(330) 759-9666
Fax
(330) 759-9668
NPI assigned
May 27, 2016
Last updated
Jul 13, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2016

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

Authorized official

Name
Mr. Roy Palumbo
Title
Partner
Phone
(330) 759-9666

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X NU Primary
Radiology Clinic/Center 261QR0200X NU

Addresses

Primary practice location

4300 Belmont Ave
Suite #6
Youngstown, OH 44505-1084

Mailing address

4300 Belmont Ave
Suite #6
Youngstown, OH 44505-1084
Phone (330) 759-9666

Other names 1

  • Liberty Open MRI Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160831000467 OH Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 3274829205 Practice locations: Youngstown, OH

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

4300 Belmont Ave
Ste 6
Youngstown, OH 44505
Phone (330) 729-3646

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1464307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468368000000",
    "number": "1023466240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 BELMONT AVE",
            "address_2": "SUITE #6",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445051084",
            "telephone_number": "330-759-9666",
            "fax_number": "330-759-9668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 BELMONT AVE",
            "address_2": "SUITE #6",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445051084",
            "telephone_number": "330-759-9666",
            "fax_number": "330-759-9668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RPJ LIBERTY ENTERPRISES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-27",
        "last_updated": "2016-07-13",
        "status": "A",
        "authorized_official_last_name": "PALUMBO",
        "authorized_official_first_name": "ROY",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "330-759-9666",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Liberty Open MRI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Youngstown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.