Inverness Medical Imaging LLC
Organization Active NPI Diagnostic Radiology Physician · Inverness, FL
NPI 1093763591 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1093763591
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- Legal business name
- INVERNESS MEDICAL IMAGING LLC
- Practice address
- 2105 State Road 44 W
Inverness, FL 34452 - Phone
- (352) 419-4818
- NPI assigned
- May 5, 2006
- Organization subpart
- No
Authorized official
- Name
- Melanie Reeser
- Title
- Facility Administrator
- Phone
- (352) 637-6100
Practitioners 109
-
John Edward Agles, M.D.
-
Dana Mark Allen, MD
-
Edilberto Raul Alvarez, M.D.
-
Rizwan Afzal Assad, M.D.
-
Amanda Cassady Aulls, M.D.
-
Jacqueline Maher Bernard, M.D.
-
Kareem I. Bohsali, M.D.
-
Alireza Bozorgmanesh, M.D.
-
Oscar F Carbonell, M.D.
-
John T Carroll, MD
-
Clayton Warren Commander, M.D., PH.D.
-
Edson Gil Cortes, MD
-
Joseph Eldon Cox, M.D.
-
James C. Cunningham, D.O.
-
William J Ford III, M.D.
-
Larry Chad Fuller, STUDENT
-
Thomas Justin Green Jr., M.D.
-
Vashti F Hellein, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (12 enrollments) in FL, AL, PR, TX, NY, UT, TN, VI, GA, SC, MI, RI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061108000195 | FL | Part B Supplier - Clinic/Group Practice | 3870590672 | Receives reassigned benefits from 95 practitioners |
| O20220909001077 | AL | Part B Supplier - Clinic/Group Practice | 3870590672 |
Receives reassigned benefits from 1 practitioner Practice locations: Hartford, AL |
| O20221019000002 | PR | Part B Supplier - Clinic/Group Practice | 3870590672 |
Receives reassigned benefits from 3 practitioners Practice locations: San Juan, PR; Guaynabo, PR |
| O20221101001937 | TX | Part B Supplier - Clinic/Group Practice | 3870590672 |
Receives reassigned benefits from 1 practitioner Practice locations: San Antonio, TX |
| O20230308001721 | NY | Part B Supplier - Clinic/Group Practice | 3870590672 | Practice locations: Dix Hills, NY; Port Washington, NY |
| O20230310001307 | UT | Part B Supplier - Clinic/Group Practice | 3870590672 |
Receives reassigned benefits from 2 practitioners Practice locations: Alpine, UT; Ogden, UT |
| O20230414000066 | TN | Part B Supplier - Clinic/Group Practice | 3870590672 | Practice locations: Nashville, TN |
| O20240325001708 | VI | Part B Supplier - Clinic/Group Practice | 3870590672 |
Receives reassigned benefits from 12 practitioners Practice locations: St. Thomas, VI; St Thomas, VI |
| O20250307001255 | GA | Part B Supplier - Clinic/Group Practice | 3870590672 |
Receives reassigned benefits from 2 practitioners Practice locations: Alpharetta, GA; Braselton, GA; Gainesville, GA |
| O20250428000690 | SC | Part B Supplier - Clinic/Group Practice | 3870590672 |
Receives reassigned benefits from 1 practitioner Practice locations: North Augusta, SC |
| O20250611003672 | MI | Part B Supplier - Clinic/Group Practice | 3870590672 |
Receives reassigned benefits from 1 practitioner Practice locations: Grand Rapids, MI |
| O20250918000559 | RI | Part B Supplier - Clinic/Group Practice | 3870590672 |
Receives reassigned benefits from 1 practitioner Practice locations: Warwick, RI |
National Provider Directory
Locations
2105 Highway 44 W
Inverness, FL 34453
Phone (352) 419-4818
9149 Estate Thomas
St Thomas, VI 00802
Phone (340) 714-2845
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | FL | Yes |
Addresses
Primary practice location
2105 State Road 44 W
Inverness, FL 34452
Mailing address
2105 Hwy 44 West
Inverness, FL 34453-3805
Phone (352) 419-4818
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 275125900 | Medicaid | FL |
Other providers in Inverness, FL
- Inspired Functional Medicine
- Integrated Regional Laboratories Pathology Services, LLC
- Inverness Family Care High Risk PLLC
- Inverness Family Practice P a
- Inverness Health
- Inverness Surgical Association P a
- Inverness Tinnitus Center
- Inverness VA Clinic
- Shajetha Thivakaran Iyathurai
- Amber Jackson
All providers in Inverness, FL · Diagnostic Radiology Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.