All-Stat Portable in LLC

Primary specialty

Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X

Legal business name

ALL-STAT PORTABLE IN LLC

Practice address

3201 Stellhorn Rd Ste A129
Fort Wayne, IN 46815-4697

Phone

(224) 337-1401

Fax

(224) 337-0401

NPI assigned

Aug 31, 2020

Last updated

Feb 9, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

ALL-STAT PORTABLE, LLCAs reported in NPPES

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

Authorized official

Name

Mr. Etai Sooliman

Title

Ceo

Phone

(224) 337-1401

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• All-Stat Portable in LLC

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Fort Wayne, IN
  • NPI 1720545296

  1254667165

  Same PAC ID

Tax ID family

All-Stat Portable in LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• All-Stat Portable in LLC

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Fort Wayne, IN
  • NPI 1720545296
  NPD tax ID

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Adel Abdalla, M.D.

  • Diagnostic Radiology Physician
  • Orlando, FL
  • NPI 1497702542
  NPD
• Edward Neyman, M.D.

  • Diagnostic Radiology Physician
  • Arlington Heights, IL
  • NPI 1104895838
  NPD
• Norman E Pennington, MD

  • Diagnostic Radiology Physician
  • Camden, NJ
  • NPI 1295728251
  NPD
• Roberto Rivera-Morales, MD

  • Diagnostic Radiology Physician
  • Weston, FL
  • NPI 1992797377
  NPD
• Robert Solomon, MD

  • Diagnostic Radiology Physician
  • Brooklyn, NY
  • NPI 1720050040
  NPD

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

{
    "created_epoch": "1598832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675900800000",
    "number": "1295348076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8235 CHRISTIANA AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762910",
            "telephone_number": "224-337-1000",
            "fax_number": "224-337-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 STELLHORN RD STE A129",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468154697",
            "telephone_number": "224-337-1401",
            "fax_number": "224-337-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALL-STAT PORTABLE IN LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALL-STAT PORTABLE, LLC",
        "enumeration_date": "2020-08-31",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A",
        "authorized_official_last_name": "SOOLIMAN",
        "authorized_official_first_name": "ETAI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "224-337-1401",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mobile Radiology Clinic/Center in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Mobile Radiology Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; 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.