Kan-Di-Ki LLC

Primary specialty

Diagnostic Ultrasound PhysicianTaxonomy code 2085U0001X

Legal business name

KAN-DI-KI LLC

Doing business as

Diagnostic Laboratories
Tridentcare

Practice address

17744 NE San Rafael St
Portland, OR 97230-5927

Phone

(800) 638-3240

Fax

(303) 576-7986

NPI assigned

Jul 12, 2010

Last updated

Mar 11, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brian C Cuomo

Title

Authorized Official/Cfo

Phone

(800) 786-8015

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 2

• DIAGNOSTIC LABORATORIES Doing business as
• Tridentcare Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Other NPIs with the same Medicare PAC ID 12

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

• Kan-Di-Ki, LLC

  dba Diagnostic Laboratories

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Portland, OR
  • NPI 1841514395

  5991737140

  Same PAC ID
• Kan-Di-Ki LLC

  dba Diagnostic Laboratories

  • Clinical Medical Laboratory
  • Irvine, CA
  • NPI 1093697757

  5991737140

  Same PAC ID
• Kan-Di-Ki LLC

  dba Diagnostic Laboratories

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Denver, CO
  • NPI 1104128859

  5991737140

  Same PAC ID
• Kan-Di-Ki LLC

  dba Diagnostic Laboratories

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Tukwila, WA
  • NPI 1124340039

  5991737140

  Same PAC ID
• Kan-Di-Ki LLC

  dba Diagnostic Laboratories

  • Diagnostic Ultrasound Physician
  • Tukwila, WA
  • NPI 1407151475

  5991737140

  Same PAC ID
• Kan-Di-Ki LLC

  dba Diagnostic Laboratories

  • Diagnostic Ultrasound Physician
  • Las Vegas, NV
  • NPI 1700198330

  5991737140

  Same PAC ID
• Kan-Di-Ki LLC

  dba Diagnostic Laboratories

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • North Hollywood, CA
  • NPI 1750364345

  5991737140

  Same PAC ID
• Kan-Di-Ki LLC

  dba Diagnostic Laboratories

  • Diagnostic Ultrasound Physician
  • Denver, CO
  • NPI 1871898841

  5991737140

  Same PAC ID
• Kan-Di-Ki LLC

  dba Diagnostic Laboratories

  • Diagnostic Ultrasound Physician
  • Phoenix, AZ
  • NPI 1992017529

  5991737140

  Same PAC ID
• Kan-Di-Ki, LLC

  dba Diagnostic Laboratories

  • Diagnostic Ultrasound Physician
  • North Hollywood, CA
  • NPI 1548422488

  5991737140

  Same PAC ID
• Kan-Di-Ki, LLC

  dba Diagnostic Laboratories

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Las Vegas, NV
  • NPI 1811210289

  5991737140

  Same PAC ID
• Kan-Di-Ki, LLC

  dba Diagnostic Laboratories

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Phoenix, AZ
  • NPI 1851613764

  5991737140

  Same PAC ID

Practitioners 23

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.

• Chad Clinton Adams, M.D.

  • Diagnostic Radiology Physician
  • Tacoma, WA
  • NPI 1447691266
  NPD
• Marc T. Awobuluyi, M.D.

  • Diagnostic Radiology Physician
  • Eden Prairie, MN
  • NPI 1962512145
  NPD
• Reono Bertagnolli, MD

  • Diagnostic Radiology Physician
  • Mooresville, NC
  • NPI 1558352948
  NPD
• Daniel William Bess, M.D.

  • Diagnostic Radiology Physician
  • Joint Base Lewis McChord, WA
  • NPI 1497092159
  NPD
• Lillian Whitley Cavin, MD

  • Diagnostic Radiology Physician
  • Spicewood, TX
  • NPI 1952363913
  NPD
• Guy Elise Constant De Gent, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Whiteville, NC
  • NPI 1558323139
  NPD
• Scott A Drummond Jr., DO

  • Diagnostic Radiology Physician
  • Edgewater, FL
  • NPI 1962552604
  NPD
• Raymond D Fisher, D.O.

  • Cardiovascular Disease Physician
  • Tacoma, WA
  • NPI 1245640515
  NPD
• Michael Hinz, M.D.

  • Diagnostic Radiology Physician
  • Chicago, IL
  • NPI 1780619155
  NPD
• Benjamin Tai-Yuen Huang, M.D.

  • Diagnostic Radiology Physician
  • La Habra, CA
  • NPI 1548289416
  NPD
• Khursheed Imam, MD

  • Diagnostic Radiology Physician
  • Roanoke, VA
  • NPI 1508828195
  NPD
• Santiago Jimenez, M.D.

  • Diagnostic Radiology Physician
  • Melbourne, FL
  • NPI 1073595740
  NPD

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

{
    "created_epoch": "1278892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773187200000",
    "number": "1083926612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 SCHILLING CIR STE 114",
            "city": "HUNT VALLEY",
            "state": "MD",
            "postal_code": "210311113",
            "telephone_number": "800-786-8015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17744 NE SAN RAFAEL ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972305927",
            "telephone_number": "800-638-3240",
            "fax_number": "303-576-7986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAN-DI-KI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-12",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A",
        "authorized_official_last_name": "CUOMO",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL/CFO",
        "authorized_official_telephone_number": "800-786-8015"
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500654573",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01099725",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DIAGNOSTIC LABORATORIES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tridentcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Louis Kammerer, LMT
• Daniel Kamna, DO
• Sean Kampel, AU.D.
• Kamran Haghighat BDS Ms PC
• Farzad Kamyar, M.D.
• Kan-Di-Ki, LLC (Diagnostic Laboratories)
• Iqbal Kana
• Talula Kana, L.M.T
• Leah Kanach, LMT
• Joshua Kanagy

• Diagnostic Ultrasound Physician in Portland, OR
• Providers in Portland, OR by specialty
• Diagnostic Ultrasound Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.