NPIMap

Organization Active NPI

Modern Nuclear, Inc.

  • Nuclear Medicine Technology Radiologic Technologist
  • La Habra, CA
National Provider Identifier
1063851335
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Medicine Technology Radiologic TechnologistTaxonomy code 2471N0900X
License
5971-30 Issued in CA
Legal business name
MODERN NUCLEAR, INC.
Practice address
511 S Harbor Blvd Ste E
La Habra, CA 90631-9375
Phone
(562) 905-2244
NPI assigned
Jun 20, 2013
Last updated
Sep 10, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Authorized official

Name
Mr. Patrick Laverty II
Title
Ceo
Phone
(562) 905-2244

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X NU
Mobile Radiology Clinic/Center 261QR0208X NU
Nuclear Medicine Technology Radiologic Technologist 2471N0900X 5971-30 CA Primary

Addresses

Primary practice location

511 S Harbor Blvd Ste E
La Habra, CA 90631-9375

Mailing address

511 S Harbor Blvd Ste E
La Habra, CA 90631-9375
Phone (562) 905-2244

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130416000652 CA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 6305851650 1 other NPI on this enrollment
Practice locations: La Habra, CA

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 65

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 65

NPI Registry JSON

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

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788998400000",
    "number": "1063851335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 S HARBOR BLVD STE E",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906319375",
            "telephone_number": "562-905-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 S HARBOR BLVD STE E",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906319375",
            "telephone_number": "562-905-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN NUCLEAR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-20",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A",
        "authorized_official_last_name": "LAVERTY",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "562-905-2244",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2471N0900X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Nuclear Medicine Technology",
            "state": "CA",
            "license": "5971-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Habra, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; 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.