NPIMap

Organization Active NPI

Impression Imaging LLC

  • Diagnostic Radiology Physician
  • Coral Springs, FL
National Provider Identifier
1104637537
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
IMPRESSION IMAGING LLC
Practice address
3111 N University Dr Ste 115
Coral Springs, FL 33065-5049
Phone
(954) 580-2780
Fax
(954) 580-2790
NPI assigned
Jan 15, 2025
Organization subpart
Yes
Parent organization
IMPRESSION IMAGING LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Authorized official

Name
Michael Fagien, MDNPI 1780680751
Title
Medical Director
Phone
(954) 580-2780

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

3111 N University Dr Ste 115
Coral Springs, FL 33065-5049

Mailing address

PO Box 21422
New York, NY 10087-1422
Phone (347) 577-9062

National Provider Directory

National Provider Directory
Tax ID family
Impression Imaging LLC4 organizations share this tax ID, including this one
Part of
Impression Imaging LLC

Other organizations with this tax ID 3

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

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": "1736899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736899200000",
    "number": "1104637537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21422",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100871422",
            "telephone_number": "347-577-9062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 N UNIVERSITY DR STE 115",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330655049",
            "telephone_number": "954-580-2780",
            "fax_number": "954-580-2790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPRESSION IMAGING LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IMPRESSION IMAGING LLC",
        "enumeration_date": "2025-01-15",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A",
        "authorized_official_last_name": "FAGIEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "954-580-2780",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.