NPIMap

Organization Active NPI

Kan-Di-Ki LLC

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Denver, CO
National Provider Identifier
1104128859
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X
Legal business name
KAN-DI-KI LLC
Practice address
11585 E 53Rd Ave Ste H
Denver, CO 80239-2321
Phone
(303) 371-0073
Fax
(443) 842-7264
NPI assigned
Dec 1, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X Primary

Addresses

Primary practice location

11585 E 53Rd Ave Ste H
Denver, CO 80239-2321

Mailing address

215 Schilling Cir Ste 114
Hunt Valley, MD 21031-1113
Phone (800) 786-8015

Other practice location 1

12075 E 45th Ave Ste 700A
Denver, CO 80239-3123
Phone (303) 371-0073

Other identifiers 2

IdentifierTypeStateIssuer
65738756MedicaidCO
P01062890OtherCORAILROAD MEDICARE

Other names 2

  • Diagnostic Laboratories Doing business as
  • TridentCare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120501000397 CO Part B Supplier - Portable X-Ray Supplier 5991737140 Practice locations: Denver, CO

Other NPIs with the same Medicare PAC ID 12

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 38

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

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1291161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773100800000",
    "number": "1104128859",
    "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": "11585 E 53RD AVE STE H",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802392321",
            "telephone_number": "303-371-0073",
            "fax_number": "443-842-7264"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12075 E 45th Ave Ste 700A",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802393123",
            "country_code": "US",
            "telephone_number": "303-371-0073",
            "fax_number": "443-842-7264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KAN-DI-KI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-01",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "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": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65738756",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01062890",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diagnostic Laboratories",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Diagnostic Laboratories",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TridentCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.