NPIMap

Organization Active NPI

Comprehensive Diagnostic Imaging of Wisconsin, LLC

  • Diagnostic Radiology Physician
  • Milwaukee, WI
National Provider Identifier
1255844106
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
COMPREHENSIVE DIAGNOSTIC IMAGING OF WISCONSIN, LLC
Practice address
2500 W Layton Ave Ste 20
Milwaukee, WI 53221-5400
Phone
(262) 261-9423
Fax
(414) 539-4185
NPI assigned
Nov 14, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2020

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

Authorized official

Name
Dr. James Mazzulla, MD
Title
Managing Member
Phone
(414) 281-2100

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary
Clinic/Center 261Q00000X
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X
Radiology Clinic/Center 261QR0200X
Mammography Clinic/Center 261QR0206X

Addresses

Primary practice location

2500 W Layton Ave Ste 20
Milwaukee, WI 53221-5400

Mailing address

2500 W Layton Ave Ste 20
Milwaukee, WI 53221-5400
Phone (262) 261-9423

National Provider Directory

National Provider Directory

Locations

2500 W Layton Ave
Ste 20
Milwaukee, WI 53221
Phone (262) 261-9423

NPI Registry JSON

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

{
    "created_epoch": "1510617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596585600000",
    "number": "1255844106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W LAYTON AVE STE 20",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532215400",
            "telephone_number": "262-261-9423",
            "fax_number": "414-539-4185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W LAYTON AVE STE 20",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532215400",
            "telephone_number": "262-261-9423",
            "fax_number": "414-539-4185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE DIAGNOSTIC IMAGING OF WISCONSIN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-14",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A",
        "authorized_official_last_name": "MAZZULLA",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "414-281-2100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2020; 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.