NPIMap

Organization Active NPI

Humboldt Radiology Medical Group,Inc.

  • Diagnostic Radiology Physician
  • New Hope, PA
National Provider Identifier
1215374194
Registry record updated May 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
HUMBOLDT RADIOLOGY MEDICAL GROUP,INC.
Practice address
6801 Circle View Dr
New Hope, PA 18938-5619
Phone
(707) 442-7814
Fax
(707) 445-3710
NPI assigned
May 31, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2013

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

Authorized official

Name
Dr. Dean Gregory Holland, M.D.
Title
Owner/Radiologist
Phone
(707) 442-7814

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

6801 Circle View Dr
New Hope, PA 18938-5619

Mailing address

PO Box 6428
Eureka, CA 95502-6428
Phone (707) 442-7814

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130621000454 PA Part B Supplier - Clinic/Group Practice 4082500046 Receives reassigned benefits from 1 practitioner
Practice locations: New Hope, PA

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Humboldt Radiology Medi8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1369958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369958400000",
    "number": "1215374194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6428",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955026428",
            "telephone_number": "707-442-7814",
            "fax_number": "707-445-3710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 CIRCLE VIEW DR",
            "city": "NEW HOPE",
            "state": "PA",
            "postal_code": "189385619",
            "telephone_number": "707-442-7814",
            "fax_number": "707-445-3710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMBOLDT RADIOLOGY MEDICAL GROUP,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-31",
        "last_updated": "2013-05-31",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "OWNER/RADIOLOGIST",
        "authorized_official_telephone_number": "707-442-7814",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hope, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2013; 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.