NPIMap

Organization Active NPI

Radiology & Imaging Specialists of Lakeland, PA

  • Diagnostic Radiology Physician
  • Kissimmee, FL
National Provider Identifier
1124530761
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
RADIOLOGY & IMAGING SPECIALISTS OF LAKELAND, PA
Practice address
3016 Dyer Boulevard
Kissimmee, FL 34741
Phone
(941) 782-9456
NPI assigned
Nov 3, 2017
Organization subpart
Yes
Parent organization
RADIOLOGY & IMAGING SPECIALISTS OF LAKELAND, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Authorized official

Name
Martha Lima, MDNPI 1437140951
Title
Treasurer
Phone
(863) 688-2334

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X

Addresses

Primary practice location

3016 Dyer Boulevard
Kissimmee, FL 34741

Mailing address

2125 Crystal Grove Dr
Lakeland, FL 33801-6875

Other names 1

  • HEALTH IMAGING SERVICES Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090306000484 FL Part B Supplier - Clinic/Group Practice 2264422294 Receives reassigned benefits from 88 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 6

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2268702Radiology and Imaging Specialists of Lakeland, PA3016 Dyer Boulevard, Kissimmee, FL 34741Certificate of waiverSep 14, 2026

National Provider Directory

National Provider Directory
Tax ID family
Radiology Imaging Spec38 organizations share this tax ID, including this one
Part of
Radiology Imaging Spec

Other organizations with this tax ID 37

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

View all 37

Locations

3016 Dyer Blvd
Kissimmee, FL 34741
Phone (941) 782-9456

1305 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 577-0251

Practitioners & affiliated clinicians

Practitioners 73

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

View all 73

NPI Registry JSON

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

{
    "created_epoch": "1509667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663286400000",
    "number": "1124530761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2125 CRYSTAL GROVE DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338016875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3016 DYER BOULEVARD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "34741",
            "telephone_number": "941-782-9456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIOLOGY & IMAGING SPECIALISTS OF LAKELAND, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RADIOLOGY & IMAGING SPECIALISTS OF LAKELAND, PA",
        "enumeration_date": "2017-11-03",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-13",
        "status": "A",
        "authorized_official_last_name": "LIMA",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "863-688-2334",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEALTH IMAGING SERVICES",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.