Individual provider Active NPI

Dustin Lee Meyer, DO

  • Diagnostic Radiology Physician
  • El Segundo, CA
National Provider Identifier
1063973881
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
OS18387 Issued in FL
Practice address
2330 Utah Ave Ste 200
El Segundo, CA 90245-4817
Phone
(281) 766-0959
NPI assigned
Mar 26, 2019
Last updated
Jan 9, 2025By the provider in NPPES
Sex
Male
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 OS18387 FL Primary

Addresses

Primary practice location

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

Mailing address

17 Davis Blvd Ste 308
Tampa, FL 33606-3438
Phone (352) 246-3512

Other practice location 1

17 Davis Blvd Ste 308
Tampa, FL 33606-3438
Phone (813) 250-2529

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240603004126 FL Practitioner - Diagnostic Radiology 0244772457 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mori Bean and Brooks Inc Diagnostic Radiology CurrentSince May 1, 2024 Accepting new patients
Tower Imaging LLC Diagnostic Radiology Current Accepting new patients
Tower Imaging LLC Diagnostic Radiology CurrentSince Jul 1, 2024 Accepting new patients
Tower Imaging LLC Diagnostic Radiology CurrentSince Jul 1, 2024 Accepting new patients

Locations

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

13695 US Highway 1
Sebastian, FL 32958
Phone (772) 589-3185

14499 N Dale Mabry Hwy
Ste 150
Tampa, FL 33618
Phone (813) 968-6998

2 Tampa General Cir
Tampa, FL 33606
Phone (813) 259-0929

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

2115 Little Rd
Trinity, FL 34655
Phone 7278418225410

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1063973881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 DAVIS BLVD STE 308",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063438",
            "telephone_number": "352-246-3512"
        },
        {
            "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": [
        {
            "address_1": "17 Davis Blvd Ste 308",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336063438",
            "country_code": "US",
            "telephone_number": "813-250-2529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEYER",
        "first_name": "DUSTIN",
        "middle_name": "LEE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-26",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "OS18387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Segundo, CA

Sources for this page

Verify at the official NPI Registry.