Individual provider Active NPI

Nisha Rao, MD

  • Diagnostic Radiology Physician
  • El Segundo, CA
National Provider Identifier
1063607216
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME 107054 Issued in FL
Practice address
2330 Utah Ave Ste 200
El Segundo, CA 90245-4817
Phone
(281) 766-0959
NPI assigned
Sep 11, 2007
Last updated
Jan 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME 107054 FL Primary

Addresses

Primary practice location

2330 Utah Ave Ste 200
El Segundo, CA 90245-4817

Mailing address

2700 University Square Dr
Radiology Assoc of Tampa
Tampa, FL 33612-5513
Phone (813) 251-5822

Other identifiers 3

IdentifierTypeStateIssuer
02965988MedicaidNY
120449MedicaidAL
002241000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, HI, NM3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20100709000784 FL Practitioner - Diagnostic Radiology 0042380107 Reassigns benefits to 6 organizations
I20230501002532 HI Practitioner - Diagnostic Radiology 0042380107 Reassigns benefits to 3 organizations
I20260601001245 NM Practitioner - Diagnostic Radiology 0042380107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
New York Medical College, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tower Imaging LLCGroup PAC ID 2860470077, 95 clinicians
Mori Bean and Brooks IncGroup PAC ID 8820077878, 966 clinicians
Intercoastal Medical Group IncGroup PAC ID 6305730912, 176 clinicians
Kauai Medical ClinicGroup PAC ID 5092628479, 147 clinicians

Practice addresses (Care Compare)

10621 Big Bend Rd
Riverview, FL 33579-7176
Phone 81325327211937

10689 Big Bend Rd
Riverview, FL 33579-7176
Phone (904) 399-5550

11505 Rangeland Pkwy
Bradenton, FL 34211-4041
Phone (941) 907-6016

14499 N Dale Mabry Hwy
Suite 150
Tampa, FL 33618-2019
Phone 81325327211937

17503 N Dale Mabry Hwy
Lutz, FL 33548-4521
Phone 81325327211937

19027 Wingshooter Way
Lutz, FL 33558-4875
Phone (813) 485-8720

2001 Kingsley Ave
Orange Park, FL 32073-5148
Phone (904) 399-5550

2106 S Lois Ave
Tampa, FL 33629-5602
Phone 81325327211937

2115 Little Rd
Trinity, FL 34655-4410
Phone 81325327211937

2324 Oak Myrtle LN
Wesley Chapel, FL 33544-6319
Phone 81325327211937

2881 Hyde Park St
Sarasota, FL 34239-3228
Phone (941) 906-7155

3-3420 Kuhio Hwy
Suite B
Lihue, HI 96766-1098
Phone (808) 245-1500

3069 Grand Pavilion Dr
Tampa, FL 33613-3757
Phone 81325327211937

3350 Bell Shoals Rd
Brandon, FL 33511-7637
Phone 81325327211937

3862 Sun City Ctr Blvd
Sun City Center, FL 33573-6806
Phone 81325327211937

3870 Tampa Rd
Oldsmar, FL 34677-3133
Phone 81325327211937

427 S Parsons Ave
Suite 100
Brandon, FL 33511-5252
Phone 81325327211937

4719 N Habana Ave
Tampa, FL 33614-7105
Phone 81325327211937

5539 Marine Pkwy
New Port Richey, FL 34652-4329
Phone 81325327211937

567 A Kaneapu PL
Kailua, HI 96734-3132
Phone (904) 399-5550

585 Kaneapu PL
Kailua, HI 96734-3132
Phone (904) 399-5550

6474 Kaahele St
Kapaa, HI 96746-9506
Phone (813) 874-7000

7525 State Rd
Suite 52
Hudson, FL 34667-6716
Phone 81325327211937

921 S Beneva Rd
Sarasota, FL 34232-2401
Phone (941) 365-7390

943 S Beneva Rd
Suite 113
Sarasota, FL 34232-2471
Phone (941) 316-0133

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 107054FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mori Bean and Brooks Inc Diagnostic Radiology CurrentSince Jul 1, 2019 Accepting new patients
Medical Technology Transfer Corporation Current Accepting new patients
University Medical Service Association Inc CurrentSince Jul 1, 2010 Accepting new patients
Medical Technology Transfer Corporation CurrentSince Dec 9, 2019 Accepting new patients
Kauai Medical Clinic CurrentSince Feb 28, 2024 Accepting new patients
Tower Imaging LLC Diagnostic Radiology CurrentSince Jul 1, 2010 Accepting new patients
Gastro Health, LLC CurrentSince Sep 12, 2022 Accepting new patients
Tower Imaging LLC Diagnostic Radiology CurrentSince Dec 22, 2024 Accepting new patients
Gastro Health LLC Current Accepting new patients
Intercoastal Medical Group Inc CurrentSince Jan 1, 2014 Accepting new patients
Tower Imaging LLC Diagnostic Radiology CurrentSince Jul 1, 2010 Accepting new patients
University Medical Service Association Inc Diagnostic Radiology CurrentSince Jul 1, 2010 Accepting new patients
Kauai Medical Clinic CurrentSince Feb 28, 2024 Accepting new patients
University Medical Service Association Inc Current Accepting new patients
Boca Radiology Group PA Diagnostic Radiology Past Accepting new patients
Brooklyn Radiology Services PC Diagnostic Radiology PastSince Jun 1, 2011 Accepting new patients
Maimonides Medical Center - MMC Radiology FPP Diagnostic Radiology Past Accepting new patients
Radiology Imaging Consultants PC Diagnostic Radiology PastSince Jan 4, 2000 Accepting new patients

Locations

3350 Bell Shoals Rd
Brandon, FL 33511
Phone (813) 654-4883

4675 Linton Blvd
Ste 202
Delray Beach, FL 33445
Phone (561) 495-5700

17503 N Dale Mabry Hwy
Lutz, FL 33548
Phone (813) 968-4540

1800 W Hibiscus Blvd
Ste 100
Melbourne, FL 32901
Phone (321) 676-3535

3661 S Miami Ave
Ste 907
Miami, FL 33133
Phone (305) 856-7333

9408 SW 87th Ave
Ste 200
Miami, FL 33176
Phone 3054684190 ext. 5003

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

7243 Della Dr
Orlando, FL 32819
Phone (407) 381-7366

921 S Beneva Rd
Sarasota, FL 34232
Phone (941) 365-7390

943 S Beneva Rd
Ste 306
Sarasota, FL 34232
Phone (941) 362-8644

12901 Bruce B Downs Blvd
#19
Tampa, FL 33612
Phone (813) 974-1469

13330 Usf Laurel Dr
Tampa, FL 33612
Phone (813) 396-9478

2 Columbia Dr
Tampa, FL 33606
Phone (813) 844-7100

2 Tampa General Cir
Fl 1
Tampa, FL 33606

2106 S Lois Ave
Tampa, FL 33629
Phone (813) 287-9370

2700 University Square Dr
Tampa, FL 33612
Phone (813) 251-5822

3416 W Swann Ave
Tampa, FL 33609
Phone (813) 877-7680

4719 N Habana Ave
Tampa, FL 33614
Phone (813) 874-9769

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-0793

2324 Oak Myrtle Ln
Wesley Chapel, FL 33544
Phone (813) 844-8300

3-3420 Kuhio Hwy
Ste B
Lihue, HI 96766
Phone (808) 245-1500

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 18

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 18

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1063607216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 UNIVERSITY SQUARE DR",
            "address_2": "RADIOLOGY ASSOC OF TAMPA",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336125513",
            "telephone_number": "813-251-5822",
            "fax_number": "813-254-4597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 UTAH AVE STE 200",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902454817",
            "telephone_number": "281-766-0959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAO",
        "first_name": "NISHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-11",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME 107054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02965988",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120449",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002241000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Segundo, CA

Sources for this page

Verify at the official NPI Registry.