Radiology Associates of Iron Mountain P L C

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

RADIOLOGY ASSOCIATES OF IRON MOUNTAIN P L C

Practice address

1721 S Stephenson Ave
Iron Mountain, MI 49801-3637

Phone

(906) 774-1313

NPI assigned

Nov 3, 2006

Organization subpart

No

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

Authorized official

Name

John Stuart To, MDNPI 1346214715

Title

President

Phone

(906) 776-5569

Specialties & licenses 1

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 7

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

• John Stuart To, MD

  • Diagnostic Radiology Physician
  • Iron Mountain, MI
  • NPI 1346214715
  Medicare reassignment NPD Authorized official
• Robyne D Camana, MD

  • Diagnostic Radiology Physician
  • Iron Mountain, MI
  • NPI 1477874238
  Medicare reassignment NPD
• Surender Kurapati, MD

  • Diagnostic Radiology Physician
  • Mount Clemens, MI
  • NPI 1073558383
  Medicare reassignment NPD
• Louis Joseph Mautone, DO

  • Diagnostic Radiology Physician
  • Iron Mountain, MI
  • NPI 1144294513
  Medicare reassignment NPD
• David Donald Timm, M.D.

  • Diagnostic Radiology Physician
  • Iron Mountain, MI
  • NPI 1114121746
  Medicare reassignment NPD
• Dan F. Kreider, M.D.

  • Diagnostic Radiology Physician
  • Green Bay, WI
  • NPI 1558372359

  MI

  Medicare reassignment NPD
• Dale Roger Shampo, MD

  • Diagnostic Radiology Physician
  • Iron Mountain, MI
  • NPI 1124107917
  NPD (past)

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672876800000",
    "number": "1154400935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 S STEPHENSON AVE",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498013637",
            "telephone_number": "906-774-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 S STEPHENSON AVE",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498013637",
            "telephone_number": "906-774-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIOLOGY ASSOCIATES OF IRON MOUNTAIN P L C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A",
        "authorized_official_last_name": "TO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "STUART",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "906-776-5569",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32880500",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPE MEDICAL PLAN",
            "identifier": "7717",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPLUS OF MI",
            "identifier": "XX13511",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECTCARE",
            "identifier": "561429",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CF8537",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR WORKCOMP",
            "identifier": "13645400",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDWEST HEALTH PLAN",
            "identifier": "020079",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "0B21023",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "95436",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsey Jo Prusi
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• Nicholas Stuart Raboin, D.C.
• Paul Raboin, O.D.
• Elizabeth Grace Ramlow, OD
• Thom Joseph Rancour, LMSW
• Christine Margaret Rattin, DO
• Ray H Cameron MD PHD
• Real Heal PLLC

• Diagnostic Radiology Physician in Iron Mountain, MI
• Providers in Iron Mountain, MI by specialty
• Diagnostic Radiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; 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.