NPIMap

Organization Active NPI

Diagnostic X-Ray Service, Inc.

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Erie, PA
National Provider Identifier
1033293709
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X
Legal business name
DIAGNOSTIC X-RAY SERVICE, INC.
Practice address
1769 West 26TH Street
Erie, PA 16508-1256
Phone
(800) 446-9729
Fax
(814) 459-6386
NPI assigned
Oct 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Authorized official

Name
Jacob Russell Wuerstle
Title
President
Phone
(814) 459-6280

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X Primary

Addresses

Primary practice location

1769 West 26TH Street
Erie, PA 16508-1256

Mailing address

1769 West 26TH Street
Erie, PA 16508-1256
Phone (800) 446-9729

Other identifiers 1

IdentifierTypeStateIssuer
0007918360002MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080417000361 PA Part B Supplier - Portable X-Ray Supplier 8921904731 Practice locations: Erie, PA

Portable X-ray supplier certification: CCN 39X0009809

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
DIAGNOSTIC X-RAY SERVICE INC
Certification status
Active
Provider type (POS)
Portable X-ray supplier
Participating since
May 18, 1979
Last certification
Apr 28, 2022
Ownership / control type
Corporation
Facility address
1769 West 26TH Street
Erie, PA 16508

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Diagnostic X-Ray Service Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

6010 N Bailey Ave
Amherst, NY 14226

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727049600000",
    "number": "1033293709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1769 WEST 26TH STREET",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165081256",
            "telephone_number": "800-446-9729",
            "fax_number": "814-459-6386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1769 WEST 26TH STREET",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165081256",
            "telephone_number": "800-446-9729",
            "fax_number": "814-459-6386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC X-RAY SERVICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A",
        "authorized_official_last_name": "WUERSTLE",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-459-6280"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007918360002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.