Organization Active NPI

Gateway Diagnostic Imaging LLC

  • Radiology Clinic/Center
  • Sherman, TX
National Provider Identifier
1053462655
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
GATEWAY DIAGNOSTIC IMAGING LLC
Practice address
221 West Travis Street
Sherman, TX 75092
Phone
(903) 771-3030
Fax
(903) 581-4050
NPI assigned
Jan 12, 2007
Last updated
Sep 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Authorized official

Name
Katrina Roelle
Title
Director of Credentialing
Phone
(614) 689-1691

Specialties & licenses 2

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

Addresses

Primary practice location

221 West Travis Street
Sherman, TX 75092

Mailing address

PO Box 746662
Atlanta, GA 30374-6662
Phone (877) 275-9077

Other practice location 1

9155 Boulevard 26 Ste 210
North Richland Hills, TX 76180-5672
Phone (817) 428-3929

Other practice location 2

3310 Live Oak St Ste 210
Dallas, TX 75204-6120
Phone (214) 935-5566

Other practice location 3

400 W Arbrook Blvd Ste 150
Arlington, TX 76014-3181
Phone (817) 776-4001

Other practice location 4

4349 S Treadaway Blvd
Abilene, TX 79602-7803
Phone (325) 695-4624

Other practice location 5

3060 Communications Pkwy Ste 103
Plano, TX 75093-8479
Phone (972) 378-3200

Other practice location 6

1106 Alston Ave Ste 175
Ft Worth, TX 76104-4644
Phone (817) 289-2002

Other practice location 7

3550 Parkwood Blvd Ste C-302
Frisco, TX 75034-1903
Phone (214) 618-3100

Other practice location 8

3021 E Renner Rd Ste 120
Richardson, TX 75082-3579
Phone (214) 428-3929

Other practice location 9

4533 Heritage Trace Pkwy Ste 1401
Fort Worth, TX 76244-8300
Phone (817) 799-6700

Other practice location 10

831 Eureka St
Weatherford, TX 76086-5807
Phone (817) 599-8995

Other practice location 11

6930 Harris Pkwy Ste 110
Ft Worth, TX 76132-4268
Phone (817) 405-6555

Other practice location 12

350 Matlock Rd Ste 100
Mansfield, TX 76063-6888
Phone (817) 592-2133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX13 enrollments

Enrollment records 13

Enrollment IDStateProvider typePAC IDDetails
O20050110000398 TX Part B Supplier - Clinic/Group Practice 9931157609 Receives reassigned benefits from 46 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20070822001450 TX Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 9032201975 Practice locations: North Richland Hills, TX
O20140627000914 TX Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 9032201975 Practice locations: Weatherford, TX
O20140701000503 TX Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 9032201975 Practice locations: Fort Worth, TX
O20150302001684 TX Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 9032201975 Practice locations: Plano, TX
O20160606001205 TX Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 9032201975 Practice locations: Frisco, TX
O20161219000567 TX Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 9032201975 Practice locations: Richardson, TX
O20180730000277 TX Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 9032201975 Practice locations: Fort Worth, TX
O20200128002097 TX Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 9032201975 Practice locations: Arlington, TX
O20200717002699 TX Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 9032201975 Practice locations: Dallas, TX
O20210427002562 TX Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 9032201975 Practice locations: Fort Worth, TX
O20210802000037 TX Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 9032201975 Practice locations: Abilene, TX
O20241211000074 TX Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 9032201975 Practice locations: Mansfield, TX

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2099361Gateway Diagnostic Imaging Weatherford831 Eureka Street, Weatherford, TX 76086Certificate of waiverJul 26, 2027
45D2099362Gateway Diagnostic Imaging Fort Worth1106 Alston Avenue Suite 175, Fort Worth, TX 76104Certificate of waiverJul 26, 2027
45D2143353Gateway Diagnostic Imaging Keller Alliance4533 Heritage Trace Parkway Suite 1401, Fort Worth, TX 76244Certificate of waiverJan 28, 2028
45D2189760Gateway Diagnostic Imaging, LLC3310 Live Oak Suite 210, Dallas, TX 75204Certificate of waiverAug 4, 2026
45D2213286Gateway Diagnostic Imaging South Fort Worth6930 Harris Pkwy Suite 110, Fort Worth, TX 76132Certificate of waiverFeb 10, 2027
45D2312426Gateway Diagnostic Imaging Mansfield350 Matlock Rd. Suite 100, Mansfield, TX 76063Certificate of waiverOct 9, 2026

National Provider Directory

National Provider Directory
Tax ID family
Consultants in Radiology PA6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Member of 2

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

Locations

400 W Arbrook Blvd
Ste 150
Arlington, TX 76014
Phone (817) 776-4001

4533 Heritage Trace Pkwy
Ste 1401
Fort Worth, TX 76244
Phone (817) 799-6700

6930 Harris Pkwy
Ste 110
Ft Worth, TX 76132
Phone (817) 405-6555

350 Matlock Rd
Ste 100
Mansfield, TX 76063
Phone (817) 592-2133

3060 Communications Pkwy
#P
Plano, TX 75093
Phone (972) 378-3200

3021 E Renner Rd
Ste 120
Richardson, TX 75082
Phone (214) 428-3929

110 W Interstate 20
Ste 120
Weatherford, TX 76086
Phone (817) 599-8995

Practitioners & affiliated clinicians

Practitioners 110

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 110

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726099200000",
    "number": "1053462655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746662",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746662",
            "telephone_number": "877-275-9077",
            "fax_number": "720-974-0370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 WEST TRAVIS STREET",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "75092",
            "telephone_number": "903-771-3030",
            "fax_number": "903-581-4050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9155 Boulevard 26 Ste 210",
            "address_purpose": "LOCATION",
            "city": "North Richland Hills",
            "state": "TX",
            "postal_code": "761805672",
            "country_code": "US",
            "telephone_number": "817-428-3929",
            "fax_number": "214-382-1903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3310 Live Oak St Ste 210",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752046120",
            "country_code": "US",
            "telephone_number": "214-935-5566",
            "fax_number": "214-393-9707",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 W Arbrook Blvd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "TX",
            "postal_code": "760143181",
            "country_code": "US",
            "telephone_number": "817-776-4001",
            "fax_number": "817-796-9678",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4349 S Treadaway Blvd",
            "address_purpose": "LOCATION",
            "city": "Abilene",
            "state": "TX",
            "postal_code": "796027803",
            "country_code": "US",
            "telephone_number": "325-695-4624",
            "fax_number": "325-695-4625",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3060 Communications Pkwy Ste 103",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750938479",
            "country_code": "US",
            "telephone_number": "972-378-3200",
            "fax_number": "972-378-3600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1106 Alston Ave Ste 175",
            "address_purpose": "LOCATION",
            "city": "Ft Worth",
            "state": "TX",
            "postal_code": "761044644",
            "country_code": "US",
            "telephone_number": "817-289-2002",
            "fax_number": "817-289-2010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3550 Parkwood Blvd Ste C-302",
            "address_purpose": "LOCATION",
            "city": "Frisco",
            "state": "TX",
            "postal_code": "750341903",
            "country_code": "US",
            "telephone_number": "214-618-3100",
            "fax_number": "214-618-8508",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3021 E Renner Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Richardson",
            "state": "TX",
            "postal_code": "750823579",
            "country_code": "US",
            "telephone_number": "214-428-3929",
            "fax_number": "214-428-1500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4533 Heritage Trace Pkwy Ste 1401",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "762448300",
            "country_code": "US",
            "telephone_number": "817-799-6700",
            "fax_number": "817-999-9114",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "831 Eureka St",
            "address_purpose": "LOCATION",
            "city": "Weatherford",
            "state": "TX",
            "postal_code": "760865807",
            "country_code": "US",
            "telephone_number": "817-599-8995",
            "fax_number": "817-599-6795",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6930 Harris Pkwy Ste 110",
            "address_purpose": "LOCATION",
            "city": "Ft Worth",
            "state": "TX",
            "postal_code": "761324268",
            "country_code": "US",
            "telephone_number": "817-405-6555",
            "fax_number": "817-484-0149",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 Matlock Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "TX",
            "postal_code": "760636888",
            "country_code": "US",
            "telephone_number": "817-592-2133",
            "fax_number": "817-592-2134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GATEWAY DIAGNOSTIC IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A",
        "authorized_official_last_name": "ROELLE",
        "authorized_official_first_name": "KATRINA",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "614-689-1691"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.