NPIMap

Organization Active NPI

Sentara Advanced Imaging Solutions, LLC

Doing business as Sentara Advanced Imaging Solutions

  • Diagnostic Radiology Physician
  • Norfolk, VA
National Provider Identifier
1154928034
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
SENTARA ADVANCED IMAGING SOLUTIONS, LLC
Doing business as
Sentara Advanced Imaging Solutions
Practice address
6201 E Virginia Beach Blvd Ste 104
Norfolk, VA 23502-2824
Phone
(757) 252-2900
NPI assigned
Oct 5, 2020
Last updated
Oct 7, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Authorized official

Name
Doris Prince
Title
Director
Phone
(757) 252-2760

Specialties & licenses 1

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

Addresses

Primary practice location

6201 E Virginia Beach Blvd Ste 104
Norfolk, VA 23502-2824

Mailing address

6201 E Virginia Beach Blvd Ste 104
Norfolk, VA 23502-2824

Other names 1

  • Sentara Advanced Imaging Solutions Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210607001761 VA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 7113327545 Receives reassigned benefits from 10 practitioners
1 other NPI on this enrollment
Practice locations: Norfolk, VA

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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
49D2334562Sentara Advanced Imaging Solutions6201 E Virginia Beach Blvd, Suite 104, Norfolk, VA 23502Certificate of waiverNov 23, 2027

National Provider Directory

National Provider Directory
Tax ID family
Sentara Advanced Imaging Solutions7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

6201 E Virginia Beach Blvd
Ste 104
Norfolk, VA 23502
Phone (757) 461-1433

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602028800000",
    "number": "1154928034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 E VIRGINIA BEACH BLVD STE 104",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235022824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 E VIRGINIA BEACH BLVD STE 104",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235022824",
            "telephone_number": "757-252-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENTARA ADVANCED IMAGING SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-05",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A",
        "authorized_official_last_name": "PRINCE",
        "authorized_official_first_name": "DORIS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "757-252-2760"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sentara Advanced Imaging Solutions",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sentara Advanced Imaging Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; 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.