Active NPI
Advanced Imaging Services, Inc
- Physiological Laboratory
- San Antonio, TX
National Provider Identifier
1184884496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physiological Laboratory
- Legal business name
- ADVANCED IMAGING SERVICES, INC
- Practice address
- 5501 Grissom Rd Ste 103
San Antonio, TX 78238-3035 - Phone
- (210) 684-0409
- Fax
- (210) 684-0260
- NPI assigned
- Jun 10, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Yvonne G Gutierrez
- Title
- Administrator
- Phone
- (210) 684-0409
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physiological Laboratory | 293D00000X | Primary |
Addresses
Primary practice location
5501 Grissom Rd Ste 103
San Antonio, TX 78238-3035
Mailing address
PO Box 380552
San Antonio, TX 78268-7552
Phone (210) 684-0409
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0881807-01 | Medicaid | TX | |
| 0879967-01 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120209000477 | TX | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 4183669401 | Practice locations: San Antonio, TX |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
- San Antonio, TX
- NPI 1841359858
4183669401
National Provider Directory
National Provider Directory- Tax ID family
- Advanced Imaging Services Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
- San Antonio, TX
- NPI 1841359858
Locations
4917 Ravenswood Dr
San Antonio, TX 78227
Phone (210) 521-7676
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Cardiovascular Disease Physician
- Austin, TX
- NPI 1700291747
-
- Diagnostic Radiology Physician
- Athens, TX
- NPI 1710926308
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213056000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1764633600000",
"number": "1184884496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 380552",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782687552",
"telephone_number": "210-684-0409",
"fax_number": "210-684-0260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5501 GRISSOM RD STE 103",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782383035",
"telephone_number": "210-684-0409",
"fax_number": "210-684-0260"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADVANCED IMAGING SERVICES, INC",
"organizational_subpart": "NO",
"enumeration_date": "2008-06-10",
"last_updated": "2025-12-02",
"certification_date": "2025-12-02",
"status": "A",
"authorized_official_last_name": "GUTIERREZ",
"authorized_official_first_name": "YVONNE",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "210-684-0409",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "293D00000X",
"taxonomy_group": "",
"desc": "Physiological Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0881807-01",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0879967-01",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.