NPIMap

Organization Active NPI

Advanced Imaging Center LLC

  • Radiology Clinic/Center
  • Schererville, IN
National Provider Identifier
1033112990
Registry record updated Feb 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
1996061345 Issued in IN
Legal business name
ADVANCED IMAGING CENTER LLC
Practice address
7860 Burr St
Schererville, IN 46375
Phone
(219) 864-2900
Fax
(219) 864-2910
NPI assigned
May 24, 2005
Last updated
Feb 24, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2009

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

Authorized official

Name
Dr. Shodhan L Patel, MDNPI 1942296462
Title
Medical Director
Phone
(219) 864-2900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X 1996061345 IN Primary

Addresses

Primary practice location

7860 Burr St
Schererville, IN 46375

Mailing address

7860 Burr St
Schererville, IN 46375
Phone (219) 864-2900

Other identifiers 1

IdentifierTypeStateIssuer
200169610MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041006001174 IN Part B Supplier - Clinic/Group Practice 5496714305 Receives reassigned benefits from 14 practitioners
Practice locations: Schererville, IN

National Provider Directory

National Provider Directory

Member of 1

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

Locations

29806 Network Pl
Chicago, IL 60673

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235433600000",
    "number": "1033112990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7860 BURR ST",
            "city": "SCHERERVILLE",
            "state": "IN",
            "postal_code": "46375",
            "telephone_number": "219-864-2900",
            "fax_number": "219-864-2910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7860 BURR ST",
            "city": "SCHERERVILLE",
            "state": "IN",
            "postal_code": "46375",
            "telephone_number": "219-864-2900",
            "fax_number": "219-864-2910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED IMAGING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2009-02-24",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "SHODHAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "219-864-2900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "IN",
            "license": "1996061345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200169610",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Schererville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2009; 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.