Farmington Imaging Center, LLC
Organization Active NPI Diagnostic Radiology Physician · Farmington, CT
NPI 1275987802 · NPPES record last updated Jun 12, 2026
Key facts
- NPI
- 1275987802
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- Legal business name
- FARMINGTON IMAGING CENTER, LLC
- Practice address
- 399 Farmington Ave Ste 130
Farmington, CT 06032-1944 - Phone
- (860) 289-3375
- NPI assigned
- Apr 20, 2016
- Organization subpart
- No
Authorized official
- Name
- Blake G Graves
- Title
- SVP, RCM
- Phone
- (312) 919-8317
Member of 3
Practitioners 209
-
Cynthia E Clarke, DO, RD
-
Daniel Collins, M.D.
-
Adriana B Dager, MD
-
Colette Martin Glaser, M.D.
-
William J. Glucksman, M.D.
-
Robert William Gordon, M.D.
-
John K Horky, M.D.
-
Timothy Huber, MD
-
Ryan W Kaliney, M.D.
-
Adam H Kaye, M.D.
-
Steve Y Lee, MD
-
Ted S Metzger, MD
-
Douglas D. Montgomery, M.D.
-
Gerard Muro, MD
-
Sean Richardson, M.D.
-
Kalpana Shah, MD
-
Yeo Yang Shin, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (30 enrollments) in CT, MA, GA, PA, NY, CA, MI, NH, VT, AZ, IL, TX, MN, DC, FL, CO, NC, SC, NV, NJ, MS, MD, OH, ID, KY, WI, TN, HI, VA, PR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20161028000552 | CT | Part B Supplier - Clinic/Group Practice | 7719265651 |
Receives reassigned benefits from 187 practitioners Practice locations: Enfield, CT; Farmington, CT |
| O20170119002813 | MA | Part B Supplier - Clinic/Group Practice | 7719265651 |
Receives reassigned benefits from 56 practitioners Practice locations: Westfield, MA; Southwick, MA; Southampton, MA; Shrewsbury, MA; Norfolk, MA; Needham, MA; Natick, MA; Longmeadow, MA… |
| O20170301001193 | GA | Part B Supplier - Clinic/Group Practice | 7719265651 |
Receives reassigned benefits from 2 practitioners Practice locations: Atlanta, GA; Jefferson, GA |
| O20170306000719 | PA | Part B Supplier - Clinic/Group Practice | 7719265651 |
Receives reassigned benefits from 11 practitioners Practice locations: Yardley, PA; Gladwyne, PA; Upper Holland, PA; Pittsburgh, PA; Philadelphia, PA; Newtown Square, PA; New Hope, PA; Jamison, PA… |
| O20180808001285 | NY | Part B Supplier - Clinic/Group Practice | 7719265651 |
Receives reassigned benefits from 5 practitioners Practice locations: Brooklyn, NY; White Plains, NY; Slingerlands, NY; New York, NY; Cedarhurst, NY |
| O20190802002150 | CA | Part B Supplier - Clinic/Group Practice | 7719265651 |
Receives reassigned benefits from 8 practitioners Practice locations: San Jose, CA; San Francisco, CA; Portola Valley, CA; Palo Alto, CA; Newport Beach, CA; Folsom, CA; Carlsbad, CA; Palm Desert, CA |
| O20210804002733 | MI | Part B Supplier - Clinic/Group Practice | 7719265651 |
Receives reassigned benefits from 1 practitioner Practice locations: Saginaw, MI |
| O20220307001187 | NH | Part B Supplier - Clinic/Group Practice | 7719265651 |
Receives reassigned benefits from 1 practitioner Practice locations: Amherst, NH |
| O20220801001062 | VT | Part B Supplier - Clinic/Group Practice | 7719265651 |
Receives reassigned benefits from 3 practitioners Practice locations: Burlington, VT; Saint Albans, VT; South Hero, VT |
| O20230119002197 | AZ | Part B Supplier - Clinic/Group Practice | 7719265651 |
Receives reassigned benefits from 8 practitioners Practice locations: Phoenix, AZ; Scottsdale, AZ; Tucson, AZ; Gilbert, AZ |
| O20230131001985 | IL | Part B Supplier - Clinic/Group Practice | 7719265651 |
Receives reassigned benefits from 6 practitioners Practice locations: Woodridge, IL; Oak Brook, IL; Lincolnwood, IL; Chicago, IL |
| O20240129000212 | TX | Part B Supplier - Clinic/Group Practice | 7719265651 |
Receives reassigned benefits from 10 practitioners Practice locations: Southlake, TX; San Antonio, TX; San Angelo, TX; Rockwall, TX; Dallas, TX; Houston, TX; Boerne, TX; Austin, TX… |
| O20240911004039 | MN | Part B Supplier - Clinic/Group Practice | 7719265651 | Practice locations: Rochester, MN |
| O20241204001107 | DC | Part B Supplier - Clinic/Group Practice | 7719265651 |
Receives reassigned benefits from 2 practitioners Practice locations: Falls Church, VA; Washington, DC |
| O20250124000044 | FL | Part B Supplier - Clinic/Group Practice | 7719265651 |
Receives reassigned benefits from 16 practitioners Practice locations: Wesley Chapel, FL; Boca Raton, FL; Vero Beach, FL; Tampa, FL; St Petersburg, FL; Satellite Beach, FL; Saint Petersburg, FL; Palm Beach Gardens, FL… |
| O20250124001717 | CO | Part B Supplier - Clinic/Group Practice | 7719265651 |
Receives reassigned benefits from 2 practitioners Practice locations: Aurora, CO; Colorado Springs, CO |
| O20250410002861 | NC | Part B Supplier - Clinic/Group Practice | 7719265651 |
Receives reassigned benefits from 1 practitioner Practice locations: Southport, NC |
| O20250411003283 | SC | Part B Supplier - Clinic/Group Practice | 7719265651 | Practice locations: North Augusta, SC |
| O20250423000761 | NV | Part B Supplier - Clinic/Group Practice | 7719265651 |
Receives reassigned benefits from 2 practitioners Practice locations: Las Vegas, NV |
| O20250425000890 | NJ | Part B Supplier - Clinic/Group Practice | 7719265651 |
Receives reassigned benefits from 1 practitioner Practice locations: Margate City, NJ |
| O20250428001051 | MS | Part B Supplier - Clinic/Group Practice | 7719265651 | Practice locations: Madison, MS |
| O20250428001744 | MD | Part B Supplier - Clinic/Group Practice | 7719265651 |
Receives reassigned benefits from 2 practitioners Practice locations: Pikesville, MD; Reisterstown, MD |
| O20250428003399 | OH | Part B Supplier - Clinic/Group Practice | 7719265651 |
Receives reassigned benefits from 4 practitioners Practice locations: Delaware, OH; Powell, OH; West Chester, OH |
| O20250505002536 | ID | Part B Supplier - Clinic/Group Practice | 7719265651 | Practice locations: Boise, ID |
| O20250509002013 | KY | Part B Supplier - Clinic/Group Practice | 7719265651 | Practice locations: Louisville, KY |
| O20250618001403 | WI | Part B Supplier - Clinic/Group Practice | 7719265651 |
Receives reassigned benefits from 1 practitioner Practice locations: Mequon, WI |
| O20250627001253 | TN | Part B Supplier - Clinic/Group Practice | 7719265651 |
Receives reassigned benefits from 1 practitioner Practice locations: Nashville, TN |
| O20251114001582 | HI | Part B Supplier - Clinic/Group Practice | 7719265651 | Practice locations: Honolulu, HI |
| O20260429000358 | VA | Part B Supplier - Clinic/Group Practice | 7719265651 |
Receives reassigned benefits from 1 practitioner Practice locations: Keswick, VA |
| O20260504005337 | PR | Part B Supplier - Clinic/Group Practice | 7719265651 |
Receives reassigned benefits from 1 practitioner Practice locations: Humacao, PR |
National Provider Directory
Locations
100 Hazard Ave
Enfield, CT 06082
Phone (860) 696-2380
111 Founders Plz
Ste 400
Hartford, CT 06108
Phone (860) 291-6554
2800 Tamarack Ave
Ste 105
South Windsor, CT 06074
Phone (860) 533-4670
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nuclear Medicine Physician |
207U00000X | |||
| Body Imaging Physician |
2085B0100X | |||
| Neuroradiology Physician |
2085N0700X | |||
| Pediatric Radiology Physician |
2085P0229X | |||
| Diagnostic Radiology Physician |
2085R0202X | Yes | ||
| Vascular & Interventional Radiology Physician |
2085R0204X |
Addresses
Primary practice location
399 Farmington Ave Ste 130
Farmington, CT 06032-1944
Mailing address
1260 Silas Deane Hwy Ste 104
Wethersfield, CT 06109-4363
Phone (860) 289-3375
Other practice location 1
100 Hazard Ave Ste 100
Enfield, CT 06082-5447
Phone (860) 289-3375
Other providers in Farmington, CT
- Farmington Care Center LLC
- Farmington Dental Associates
- Farmington Dental PLLC
- Farmington Family Dental Group, PLLC
- Farmington Family Dentistry, LLC
- Farmington Pediatric & Adolescent Medicine, LLC
- Farmington Public Schools
- Farmington Rehab Center, LLC
- Farmington Surgery Center LLC
- Farmington Village Dental Associates, LLC
All providers in Farmington, CT · Diagnostic Radiology Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.