Advanced Imaging Diagnostics LLC

Primary specialty

Nuclear Cardiology PhysicianTaxonomy code 207UN0901X

License

D0026012 Issued in MD

Legal business name

ADVANCED IMAGING DIAGNOSTICS LLC

Doing business as

Advanced Imaging Diagnostics LLC

Practice address

12501 Prosperity Dr Ste 330
Silver Spring, MD 20904-1655

Phone

(301) 604-4033

Fax

(240) 645-4013

NPI assigned

Apr 16, 2018

Last updated

Jul 31, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Adaora Perpetua Noummy

Title

Administration Officer

Phone

(240) 899-5315

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• ADVANCED IMAGING DIAGNOSTICS LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Tax ID family

Advanced Imaging Diagnostics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Advanced Imaging Diagnostics

  • Nuclear Cardiology Physician
  • Silver Spring, MD
  • NPI 1487435087
  NPD tax ID

Practitioners 1

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.

• Andrew Keenan, M.D.

  • Nuclear Imaging & Therapy Physician
  • Largo, MD
  • NPI 1467405175
  NPD

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

{
    "created_epoch": "1523836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722384000000",
    "number": "1225525256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12501 PROSPERITY DR STE 330",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209041655",
            "telephone_number": "240-899-5315",
            "fax_number": "877-253-6952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12501 PROSPERITY DR STE 330",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209041655",
            "telephone_number": "301-604-4033",
            "fax_number": "240-645-4013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED IMAGING DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-16",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A",
        "authorized_official_last_name": "NOUMMY",
        "authorized_official_first_name": "ADAORA",
        "authorized_official_middle_name": "PERPETUA",
        "authorized_official_title_or_position": "ADMINISTRATION OFFICER",
        "authorized_official_telephone_number": "240-899-5315"
    },
    "taxonomies": [
        {
            "code": "207UN0901X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "MD",
            "license": "D0026012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "331441300",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL",
            "identifier": "502474",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ADVANCED IMAGING DIAGNOSTICS LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nuclear Cardiology Physician in Silver Spring, MD
• Providers in Silver Spring, MD by specialty
• Nuclear Cardiology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.