NPIMap

Organization Active NPI

Jefferson University Radiology Associates LLC

  • Radiology Clinic/Center
  • Collegeville, PA
National Provider Identifier
1154576114
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
JEFFERSON UNIVERSITY RADIOLOGY ASSOCIATES LLC
Practice address
534 2ND Ave # RT.29
Ste 102
Collegeville, PA 19426-2654
Phone
(610) 831-0500
Fax
(610) 831-8989
NPI assigned
Nov 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Authorized official

Name
Amy Stout
Title
President/Ceo
Phone
(615) 261-2306

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

534 2ND Ave # RT.29
Ste 102
Collegeville, PA 19426-2654

Mailing address

800 Crescent Centre Dr Ste 400
Franklin, TN 37067-7270
Phone (615) 261-2306

Other names 1

  • Jefferson Outpatient Imaging Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY, VA, DC, AL5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
O20070625000322 PA Part B Supplier - Clinic/Group Practice 7315845708 Receives reassigned benefits from 132 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Collegeville, PA; East Norriton, PA; Malvern, PA; Philadelphia, PA
O20231104000087 NY Part B Supplier - Clinic/Group Practice 7315845708 Receives reassigned benefits from 1 practitioner
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Southampton, NY
O20240202002916 VA Part B Supplier - Clinic/Group Practice 7315845708 Receives reassigned benefits from 1 practitioner
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mechanicsville, VA
O20240509002047 DC Part B Supplier - Clinic/Group Practice 7315845708 Receives reassigned benefits from 1 practitioner
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chevy Chase, MD
O20250617001561 AL Part B Supplier - Clinic/Group Practice 7315845708 Receives reassigned benefits from 1 practitioner
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Vestavia Hills, AL

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

534 Second Ave
Ste 102
Collegeville, PA 19426
Phone (610) 831-0500

3 Crescent Dr
Ste 1002
Philadelphia, PA 19112
Phone (215) 503-4900

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1226966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765843200000",
    "number": "1154576114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CRESCENT CENTRE DR STE 400",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370677270",
            "telephone_number": "615-261-2306",
            "fax_number": "855-588-3545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "534 2ND AVE # RT.29",
            "address_2": "STE 102",
            "city": "COLLEGEVILLE",
            "state": "PA",
            "postal_code": "194262654",
            "telephone_number": "610-831-0500",
            "fax_number": "610-831-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON UNIVERSITY RADIOLOGY ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-18",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A",
        "authorized_official_last_name": "STOUT",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "615-261-2306"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jefferson Outpatient Imaging",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jefferson Outpatient Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Collegeville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; 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.