NPIMap

Organization Active NPI

Presgar Imaging of Rockledge LLC

Doing business as Open MRI of Rockledge

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Rockledge, FL
National Provider Identifier
1225015357
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
License
HCC5110 Issued in FL
Legal business name
PRESGAR IMAGING OF ROCKLEDGE LLC
Doing business as
Open MRI of Rockledge
Practice address
1978 Rockledge Blvd
Suite 101
Rockledge, FL 32955-3722
Phone
(321) 633-1600
Fax
(321) 633-0433
NPI assigned
Dec 29, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

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

Authorized official

Name
Robbie Robertson
Title
President and Ceo
Phone
(813) 323-2594

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X HCC5110 FL Primary

Addresses

Primary practice location

1978 Rockledge Blvd
Suite 101
Rockledge, FL 32955-3722

Mailing address

23110 State Rd 54
PMB 292
Lutz, FL 33549-2921
Phone (352) 578-2055

Other identifiers 2

IdentifierTypeStateIssuer
CG5418OtherFLRAILROAD MEDICARE
257947200MedicaidFL

Other names 1

  • Open MRI of Rockledge Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080105000041 FL Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 9739151903 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Rockledge, FL

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Maximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Practitioners & affiliated clinicians

Practitioners 8

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": "1135814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635379200000",
    "number": "1225015357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23110 STATE RD 54",
            "address_2": "PMB 292",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335492921",
            "telephone_number": "352-578-2055",
            "fax_number": "813-971-0818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1978 ROCKLEDGE BLVD",
            "address_2": "SUITE 101",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553722",
            "telephone_number": "321-633-1600",
            "fax_number": "321-633-0433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESGAR IMAGING OF ROCKLEDGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-29",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "ROBBIE",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "813-323-2594"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "FL",
            "license": "HCC5110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CG5418",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "257947200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Open MRI of Rockledge",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Open MRI of Rockledge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rockledge, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; 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.