NPIMap

Organization Active NPI

Newport Center Radiology Medical Group Inc.

Doing business as Tustin Imaging Center

  • Radiology Clinic/Center
  • Tustin, CA
National Provider Identifier
1205304433
Registry record updated Nov 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
NEWPORT CENTER RADIOLOGY MEDICAL GROUP INC.
Doing business as
Tustin Imaging Center
Practice address
15000 Kensington Park Dr
Tustin, CA 92782-1830
Phone
(714) 477-8340
Fax
(714) 477-8341
NPI assigned
Nov 6, 2018
Last updated
Nov 26, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
NEWPORT CENTER RADIOLOGY MEDICAL GROUP INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 26, 2018

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

Authorized official

Name
Michael C Roossin, MD
Title
President
Phone
(949) 263-8620

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

15000 Kensington Park Dr
Tustin, CA 92782-1830

Mailing address

Dept la 21705
Pasadena, CA 91185-1705
Phone (949) 263-8620

Other names 1

  • Tustin Imaging Center Doing business as

National Provider Directory

National Provider Directory
Part of
Newport Center Radiology Medical Group Inc

Locations

Dept LA 21705
Pasadena, CA 91185

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1541462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543190400000",
    "number": "1205304433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT LA 21705",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911851705",
            "telephone_number": "949-263-8620",
            "fax_number": "714-727-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15000 KENSINGTON PARK DR",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927821830",
            "telephone_number": "714-477-8340",
            "fax_number": "714-477-8341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWPORT CENTER RADIOLOGY MEDICAL GROUP INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEWPORT CENTER RADIOLOGY MEDICAL GROUP INC.",
        "enumeration_date": "2018-11-06",
        "last_updated": "2018-11-26",
        "status": "A",
        "authorized_official_last_name": "ROOSSIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-263-8620",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tustin Imaging Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.