NPIMap

Organization Active NPI

Central Valley Imaging Medical Associates, Inc

  • Diagnostic Radiology Physician
  • Manteca, CA
National Provider Identifier
1295218204
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
CENTRAL VALLEY IMAGING MEDICAL ASSOCIATES, INC
Practice address
250 Cherry LN Ste 116
Manteca, CA 95337-4398
Phone
(209) 647-2184
NPI assigned
Sep 14, 2018
Last updated
Jul 10, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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

Authorized official

Name
Richard M Porzio, MD
Title
President
Phone
(209) 647-2184

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

250 Cherry LN Ste 116
Manteca, CA 95337-4398

Mailing address

PO Box 398076
San Francisco, CA 94139-8076
Phone (209) 647-2184

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170403002417 TX Part B Supplier - Clinic/Group Practice 8628064953 Receives reassigned benefits from 7 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tyler, TX; Spring, TX; San Antonio, TX; Plano, TX; Leander, TX; Corpus Christi, TX; Houston, TX; El Paso, TX

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1536883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562716800000",
    "number": "1295218204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 398076",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941398076",
            "telephone_number": "209-647-2184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 CHERRY LN STE 116",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953374398",
            "telephone_number": "209-647-2184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL VALLEY IMAGING MEDICAL ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-14",
        "last_updated": "2019-07-10",
        "status": "A",
        "authorized_official_last_name": "PORZIO",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-647-2184",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manteca, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; 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.