NPIMap

Organization Active NPI

Advanced Imaging of Lafayette LLC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Lafayette, LA
National Provider Identifier
1093784761
Registry record updated Dec 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
Legal business name
ADVANCED IMAGING OF LAFAYETTE LLC
Practice address
935 Camellia Blvd
Suite 101
Lafayette, LA 70508-7084
Phone
(333) 984-2036
Fax
(337) 984-7604
NPI assigned
Mar 15, 2006
Last updated
Dec 30, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2019

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

Authorized official

Name
Minal Amin
Title
VP Finance
Phone
(800) 544-3215

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X Primary

Addresses

Primary practice location

935 Camellia Blvd
Suite 101
Lafayette, LA 70508-7084

Mailing address

18201 Von Karman Ave Ste 600
Irvine, CA 92612-1176
Phone (800) 544-3215

Other identifiers 3

IdentifierTypeStateIssuer
1601489OtherLAUNITED OF LA
2193687OtherLAFIRST HEALTH/CCN
7266595OtherLAAETNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040824000062 LA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 5193799377 Practice locations: Lafayette, LA

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

935 Camellia Blvd
Lafayette, LA 70508
Phone (337) 984-2036

Practitioners & affiliated clinicians

Practitioners 22

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 22

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577664000000",
    "number": "1093784761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18201 VON KARMAN AVE STE 600",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926121176",
            "telephone_number": "800-544-3215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 CAMELLIA BLVD",
            "address_2": "SUITE 101",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705087084",
            "telephone_number": "333-984-2036",
            "fax_number": "337-984-7604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED IMAGING OF LAFAYETTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-15",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A",
        "authorized_official_last_name": "AMIN",
        "authorized_official_first_name": "MINAL",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "800-544-3215"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED OF LA",
            "identifier": "1601489",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH/CCN",
            "identifier": "2193687",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7266595",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2019; 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.