Monticello Diagnostic Imaging LP

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

MONTICELLO DIAGNOSTIC IMAGING LP

Doing business as

Elite Diagnostic Imaging

Practice address

3712 W 7TH St
Ft Worth, TX 76107-2536

Phone

(817) 377-3800

NPI assigned

May 13, 2006

Last updated

Dec 26, 2024By 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

Chelsea Holder

Title

Practice Admin

Phone

(817) 377-3800

Specialties & licenses 2

Addresses

Other names 1

• Elite Diagnostic Imaging Doing business as

Medicare fee-for-service enrollment

Enrolled in TX2 enrollments

Enrollment records 2

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

CLIA laboratory certificates

Locations

Practitioners 4

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.

• John Peter Fitzsimons, M.D.

  • Vascular & Interventional Radiology Physician
  • Garland, TX
  • NPI 1780613240

  Diagnostic Radiology

  NPD
• Rodolfo Luis Garcia, M.D.

  • Diagnostic Radiology Physician
  • Edinburg, TX
  • NPI 1487736583
  NPD
• Nicholas Gregory Iwasko, M.D.

  • Diagnostic Radiology Physician
  • Dallas, TX
  • NPI 1285649863
  NPD
• Michael Anthony Davis, MD

  • Diagnostic Radiology Physician
  • San Diego, CA
  • NPI 1235441627
  NPD

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735171200000",
    "number": "1033160015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7668 ELDORADO PKWY STE 200",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750705753",
            "telephone_number": "817-377-3800",
            "fax_number": "817-377-3801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3712 W 7TH ST",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761072536",
            "telephone_number": "817-377-3800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1713 S Fm 51 Ste 103",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "TX",
            "postal_code": "762343644",
            "country_code": "US",
            "telephone_number": "940-627-2570",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3160 N Tarrant Pkwy Ste 400",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761778631",
            "country_code": "US",
            "telephone_number": "817-591-4624",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5668 Edwards Ranch Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761094108",
            "country_code": "US",
            "telephone_number": "817-701-1100",
            "fax_number": "817-377-3801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17051 Dallas Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Addison",
            "state": "TX",
            "postal_code": "750017119",
            "country_code": "US",
            "telephone_number": "972-338-9760",
            "fax_number": "817-377-3801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 N Ridgeway Ct",
            "address_purpose": "LOCATION",
            "city": "Cleburne",
            "state": "TX",
            "postal_code": "760334180",
            "country_code": "US",
            "telephone_number": "682-317-9178",
            "fax_number": "817-377-3801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2401 Ira E Woods Ave Ste 600",
            "address_purpose": "LOCATION",
            "city": "Grapevine",
            "state": "TX",
            "postal_code": "760518631",
            "country_code": "US",
            "telephone_number": "817-488-9991",
            "fax_number": "817-377-3801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5616 Warren Pkwy Ste 102",
            "address_purpose": "LOCATION",
            "city": "Frisco",
            "state": "TX",
            "postal_code": "750344166",
            "country_code": "US",
            "telephone_number": "469-305-0060",
            "fax_number": "817-377-3801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MONTICELLO DIAGNOSTIC IMAGING LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-13",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A",
        "authorized_official_last_name": "HOLDER",
        "authorized_official_first_name": "CHELSEA",
        "authorized_official_title_or_position": "PRACTICE ADMIN",
        "authorized_official_telephone_number": "817-377-3800"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Diagnostic Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Randy Joe Montgomery, MD
• Sarah Montgomery, OTR
• Tiffany Christeen Montgomery, MOT
• Vanessa Jean Montgomery, PHARMD
• Monticello Chiropractic PLLC
• Yolanda Montiel, APRN, PMNHP-BC
• Jennifer Elizabeth Montoya, LPC ASSOCIATE
• Stephanie Montoya
• Monty V. Trimble , MD, P.a
• Erica Moody

• Diagnostic Radiology Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Diagnostic Radiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 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.