Organization Active NPI

Medical Scanning Consultants, P.a.

  • Diagnostic Radiology Physician
  • Bloomington, IN
National Provider Identifier
1093166274
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
MEDICAL SCANNING CONSULTANTS, P.A.
Practice address
3802 W Industrial Blvd
Suite 4
Bloomington, IN 47403-5141
Phone
(812) 331-7727
Fax
(812) 331-8983
NPI assigned
Jun 28, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Authorized official

Name
Patrick M. Bakker
Title
Cfo
Phone
(952) 543-6504

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

3802 W Industrial Blvd
Suite 4
Bloomington, IN 47403-5141

Mailing address

5775 Wayzata Blvd
Suite 400
St Louis Park, MN 55416-1222
Phone (952) 525-6338

Other names 1

  • RAYUS RADIOLOGY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040302000246 IN Part B Supplier - Clinic/Group Practice 9032005376 Receives reassigned benefits from 16 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Terre Haute, IN; Noblesville, IN; Lafayette, IN; Indianapolis, IN; Fishers, IN; Greenwood, IN; Avon, IN; Carmel, IN…

Other NPIs on the same Medicare enrollment 2

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
15D2134690Rayus Radiology3802 Industrial Blvd, Suite 4, Bloomington, IN 47403Certificate of waiverAug 7, 2027

National Provider Directory

National Provider Directory
Tax ID family
Medical Scanning Consultants PA7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

3802 W Industrial Blvd
Ste 4
Bloomington, IN 47403
Phone (812) 331-7727

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632355200000",
    "number": "1093166274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5775 WAYZATA BLVD",
            "address_2": "SUITE 400",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161222",
            "telephone_number": "952-525-6338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3802 W INDUSTRIAL BLVD",
            "address_2": "SUITE 4",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035141",
            "telephone_number": "812-331-7727",
            "fax_number": "812-331-8983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL SCANNING CONSULTANTS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-28",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A",
        "authorized_official_last_name": "BAKKER",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "952-543-6504"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RAYUS RADIOLOGY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.