Organization Active NPI

Omic LLC

Doing business as Oakland MRI Imaging Center

  • Specialist
  • Troy, MI
National Provider Identifier
1285754515
Registry record updated Jul 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
OMIC LLC
Doing business as
Oakland MRI Imaging Center
Practice address
5119 Rochester Rd
Troy, MI 48085-3426
Phone
(248) 740-0777
Fax
(248) 740-0777
NPI assigned
Mar 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2008

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

Authorized official

Name
Mr. Allie Galovich
Title
Business Manager
Phone
(248) 681-8187

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

5119 Rochester Rd
Troy, MI 48085-3426

Mailing address

5119 Rochester Rd
Troy, MI 48085-3426
Phone (248) 740-0777

Other identifiers 2

IdentifierTypeStateIssuer
300F359020OtherMIBCBSM
166815OtherMIGLHP

Other names 1

  • Oakland MRI Imaging Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080226000095 MI Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 6800970187 Practice locations: Troy, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2027055Oakland MRI5119 Rochester Road, Troy, MI 48085Certificate of waiverJul 14, 2027

National Provider Directory

National Provider Directory

Locations

2243 Momentum Pl
Chicago, IL 60689

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215388800000",
    "number": "1285754515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5119 ROCHESTER RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480853426",
            "telephone_number": "248-740-0777",
            "fax_number": "248-740-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5119 ROCHESTER RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480853426",
            "telephone_number": "248-740-0777",
            "fax_number": "248-740-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2008-07-07",
        "status": "A",
        "authorized_official_last_name": "GALOVICH",
        "authorized_official_first_name": "ALLIE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "248-681-8187",
        "authorized_official_name_prefix": "Mr."
    },
    "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": "BCBSM",
            "identifier": "300F359020",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GLHP",
            "identifier": "166815",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oakland MRI Imaging Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.