John Jiang, MD

Individual provider Active NPI Diagnostic Radiology Physician · NLV, NV

NPI 1255412490 · NPPES record last updated Jul 13, 2015

Key facts

NPI
1255412490
Entity type
Individual (NPI type 1)
Primary specialty
Diagnostic Radiology Physician 2085R0202X
License
4301086939 (MI)
Practice address
6900 N Pecos Rd
NLV, NV 89086
Phone
(702) 791-9000
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Diagnostic Radiology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Basha Diagnostics P C (28 clinicians)

Practice addresses (Care Compare)

30701 Woodward Ave
Suite LL
Royal Oak, MI 48073-0988
Phone (248) 288-1600

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20060323000336 MI Practitioner - Diagnostic Radiology 1658388533 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Basha Diagnostics P C Diagnostic Radiology Current
since Mar 1, 2023
Accepting new patients

Locations

30701 Woodward Ave
Ste Ll
Royal Oak, MI 48073
Phone (248) 288-1600

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 4301086939 MI Yes

Addresses

Primary practice location

6900 N Pecos Rd
NLV, NV 89086

Mailing address

6900 N Pecos Rd
NLV, NV 89086
Phone (702) 791-9000

Other identifiers

IdentifierTypeStateIssuer
4845176MedicaidMI

Other providers in NLV, NV

All providers in NLV, NV · Diagnostic Radiology Physician in Nevada

Sources for this page

Verify at the official NPI Registry.