Active NPI
MD Diagnostic Specialist, LLC
- Specialist
- Maitland, FL
National Provider Identifier
1285744870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Legal business name
- MD DIAGNOSTIC SPECIALIST, LLC
- Practice address
- 668 N Orlando Ave
Suite 1005
Maitland, FL 32751-4473 - Phone
- (407) 740-8848
- Fax
- (407) 740-0324
- NPI assigned
- Aug 30, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Peter E. Weinberg, MD
- Title
- Director
- Phone
- (407) 740-8848
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Primary |
Addresses
Primary practice location
668 N Orlando Ave
Suite 1005
Maitland, FL 32751-4473
Mailing address
668 N Orlando Ave
Suite 1005
Maitland, FL 32751-4473
Phone (407) 740-8848
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| V3206 | Other | FL | BCBS |
| 9376098 | Other | FL | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070112000333 | FL | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 9830199942 | Practice locations: Maitland, FL |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physical Medicine & Rehabilitation Physician
- Maitland, FL
- NPI 1013910314
-
- Diagnostic Radiology Physician
- Winter Springs, FL
- NPI 1699738518
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1435276800000",
"number": "1285744870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "668 N ORLANDO AVE",
"address_2": "SUITE 1005",
"city": "MAITLAND",
"state": "FL",
"postal_code": "327514473",
"telephone_number": "407-740-8848",
"fax_number": "407-740-0324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "668 N ORLANDO AVE",
"address_2": "SUITE 1005",
"city": "MAITLAND",
"state": "FL",
"postal_code": "327514473",
"telephone_number": "407-740-8848",
"fax_number": "407-740-0324"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MD DIAGNOSTIC SPECIALIST, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-30",
"last_updated": "2015-06-26",
"status": "A",
"authorized_official_last_name": "WEINBERG",
"authorized_official_first_name": "PETER",
"authorized_official_middle_name": "E.",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "407-740-8848",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "V3206",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "9376098",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Maitland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2015; 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.