Smi Imaging LLC

Organization Active NPI Diagnostic Radiology Physician · Las Vegas, NV

NPI 1114563095 · NPPES record last updated Jul 27, 2020

Key facts

NPI
1114563095
Entity type
Organization (NPI type 2)
Primary specialty
Diagnostic Radiology Physician 2085R0202X
Legal business name
SMI IMAGING LLC
Practice address
7540 Oso Blanca Rd Ste 140
Las Vegas, NV 89149-1417
Phone
(702) 658-4300
NPI assigned
Nov 26, 2019
Organization subpart
No

Authorized official

Name
Howard John Simon, MD
Title
Ceo
Phone
(480) 478-6545

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 3

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

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
29D2145800Simonmed Imaging-Centennial
7540 Oso Blanca Rd Ste 140, Las Vegas, NV 89149
Certificate of waiverMar 14, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NV

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20180824000170 NV Part B Supplier - Clinic/Group Practice 3476696220 Receives reassigned benefits from 56 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2085R0202X Yes

Addresses

Primary practice location

7540 Oso Blanca Rd Ste 140
Las Vegas, NV 89149-1417

Mailing address

6900 E Camelback Rd Ste 700
Scottsdale, AZ 85251-2400
Phone (866) 614-8555

Other names

  • SIMONMED IMAGING Doing business as

Other providers in Las Vegas, NV

All providers in Las Vegas, NV · Diagnostic Radiology Physician in Nevada

Sources for this page

Verify at the official NPI Registry.