Diagnostic Imaging PA

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

DIAGNOSTIC IMAGING PA

Practice address

1052 Ponte Vedra Blvd
Ponte Vedra Beach, FL 32082-4015

Phone

(904) 551-0703

Fax

(904) 551-0709

NPI assigned

Dec 29, 2008

Organization subpart

No

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

Authorized official

Name

Shahid M Nasir, MDNPI 1811904238

Title

President

Phone

(904) 629-6733

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 6

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

• Shahid M Nasir, MD

  • Diagnostic Radiology Physician
  • Ponte Vedra Beach, FL
  • NPI 1811904238
  Medicare reassignment NPD Authorized official
• Paul L Vitulli, DO

  • Vascular & Interventional Radiology Physician
  • Ponte Vedra Beach, FL
  • NPI 1932142114

  Diagnostic Radiology

  Medicare reassignment NPD
• Megan E Deacon-Casey, MD

  • Vascular & Interventional Radiology Physician
  • Ponte Vedra Beach, FL
  • NPI 1235112517
  Medicare reassignment
• Kok L. Chong, MD

  • Vascular & Interventional Radiology Physician
  • Saint Augustine, FL
  • NPI 1972681542
  NPD (past)
• Jody B Stucky, M.D.

  • Diagnostic Radiology Physician
  • North Miami Beach, FL
  • NPI 1770646457
  NPD (past)
• Arlette N Shvartzman, MD

  • Diagnostic Radiology Physician
  • Middletown, NY
  • NPI 1922071851
  NPD (past)

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

{
    "created_epoch": "1230508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633564800000",
    "number": "1285870089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 CORRIDOR RD UNIT 428",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320047718",
            "telephone_number": "904-551-0703",
            "fax_number": "904-551-0709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1052 PONTE VEDRA BLVD",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320824015",
            "telephone_number": "904-551-0703",
            "fax_number": "904-551-0709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC IMAGING PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-29",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A",
        "authorized_official_last_name": "NASIR",
        "authorized_official_first_name": "SHAHID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-629-6733",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000703600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah D. Hanna LCSW PA
• John Michael Dellaporta, D.M.D.
• Desmond Bell, DPM. CWS, P.a.
• Melanie P Desmond, M.A. SLP-CCC
• Carolyn Irene Dewane, RD,LD
• Jorge Andres Diaz, M.D.
• Cheryl Anne Dietly
• Michaela Mayol Dimain, APRN
• Adam Dimitrov, MD
• Andrea Distefano, FNP-BC

• Diagnostic Radiology Physician in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Diagnostic Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; 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.

Verify at the official NPI Registry.