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Jackson Radiology Consultants, P C

Organization Active NPI Diagnostic Radiology Physician · Jackson, MI

NPI 1295736015 · NPPES record last updated Feb 2, 2024

Key facts

NPI
1295736015
Entity type
Organization (NPI type 2)
Primary specialty
Diagnostic Radiology Physician 2085R0202X
Legal business name
JACKSON RADIOLOGY CONSULTANTS, P C
Practice address
205 N East Ave
Imaging Department
Jackson, MI 49201-1753
Phone
(517) 783-2612
Fax
(517) 783-5991
NPI assigned
Aug 2, 2005
Organization subpart
No

Authorized official

Name
Piyush C Patel, M.D. NPI 1770584948
Title
President
Phone
(517) 783-2612

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 21

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled (4 enrollments) in MI, CA, FL, IA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040526000669 MI Part B Supplier - Clinic/Group Practice 1254312267 Receives reassigned benefits from 13 practitioners
Practice locations: Jackson, MI
O20240304002484 CA Part B Supplier - Clinic/Group Practice 1254312267 Receives reassigned benefits from 1 practitioner
Practice locations: Riverside, CA
O20240916000191 FL Part B Supplier - Clinic/Group Practice 1254312267 Receives reassigned benefits from 1 practitioner
Practice locations: Sebring, FL
O20250714001806 IA Part B Supplier - Clinic/Group Practice 1254312267 Receives reassigned benefits from 1 practitioner
Practice locations: Cedar Falls, IA

National Provider Directory

Locations

3305 Spring Arbor Rd
Ste 100
Jackson, MI 49203
Phone (517) 205-7474

600 S Brown St
Jackson, MI 49203
Phone (505) 690-4159

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 2085R0202X MI Yes

Addresses

Primary practice location

205 N East Ave
Imaging Department
Jackson, MI 49201-1753

Mailing address

2800 Spring Arbor Rd Ste 102
PO Box 905
Jackson, MI 49203-3895
Phone (517) 783-2612

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 2, 2024.

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706832000000",
    "number": "1295736015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 SPRING ARBOR RD STE 102",
            "address_2": "PO BOX 905",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492033895",
            "telephone_number": "517-783-2612",
            "fax_number": "517-783-5991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "address_2": "IMAGING DEPARTMENT",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-783-2612",
            "fax_number": "517-783-5991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON RADIOLOGY CONSULTANTS, P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-02",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "PIYUSH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "517-783-2612",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

All providers in Jackson, MI · Diagnostic Radiology Physician in Michigan

Sources for this page

Verify at the official NPI Registry.