Bridgeway Diagnostic Radiology
Organization Active NPI Diagnostic Radiology Physician · Phenix City, AL
NPI 1306248729 · NPPES record last updated Jul 28, 2023
Key facts
- NPI
- 1306248729
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- Legal business name
- BRIDGEWAY DIAGNOSTIC RADIOLOGY
- Practice address
- 5007 Summerville Road
Phenix City, AL 36867-1559 - Phone
- (334) 408-2854
- Fax
- (334) 384-9274
- NPI assigned
- Sep 17, 2014
- Organization subpart
- No
Authorized official
- Name
- Dr. Jason Hoover, M.D.
- Title
- M.D./Owner
- Phone
- (334) 408-2854
Practitioners 33
-
Jason A Hoover, M.D.
-
John W Mitchell, MD
-
Mathieu Nader, M.D.
-
Jeffery A Stone, D.O.
-
Brian Neil Valentine, M.D.
-
Jason A Foerter, MD
-
Carlos M Garcia, M.D.
-
Quinn S Millington, DPT
-
Adel Abdalla, M.D.
-
Derek R Armfield, MD
-
Jeremy Ferris, M.D.
-
Kyle James Martinos, DPT
-
Philip B. McDonald, M.D.
-
Justin Hung Pham, M.D.
-
Cary Rose, MD
-
Stephen M Sabourin, M.D.
-
Amjad Ali Safvi, MD
-
Amit Kumar Sanghi, D.O.
-
Rajneesh Sehgal, M.D.
-
Mark Simmons, DPT
-
Ross Varma, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 01D2086760 | Bridgeway Diagnostic Radiology, LLC | Certificate of waiver | Nov 11, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (8 enrollments) in AL, GA, CA, SC, FL, IL, PA, TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150108001370 | AL | Part B Supplier - Clinic/Group Practice | 8224351788 |
Receives reassigned benefits from 17 practitioners Practice locations: Auburn, AL; Phenix City, AL |
| O20190604001681 | GA | Part B Supplier - Clinic/Group Practice | 8224351788 |
Receives reassigned benefits from 7 practitioners Practice locations: Columbus, GA |
| O20230720003099 | CA | Part B Supplier - Clinic/Group Practice | 8224351788 |
Receives reassigned benefits from 2 practitioners Practice locations: Glendale, CA; Newport Beach, CA |
| O20230731001098 | SC | Part B Supplier - Clinic/Group Practice | 8224351788 |
Receives reassigned benefits from 1 practitioner Practice locations: Blythewood, SC |
| O20230802000030 | FL | Part B Supplier - Clinic/Group Practice | 8224351788 |
Receives reassigned benefits from 4 practitioners Practice locations: Jacksonville, FL; Melbourne, FL; Orlando, FL; Weston, FL; Delray Beach, FL |
| O20230824003549 | IL | Part B Supplier - Clinic/Group Practice | 8224351788 |
Receives reassigned benefits from 1 practitioner Practice locations: Lake Zurich, IL |
| O20230831000132 | PA | Part B Supplier - Clinic/Group Practice | 8224351788 |
Receives reassigned benefits from 1 practitioner Practice locations: Presto, PA |
| O20230921000880 | TX | Part B Supplier - Clinic/Group Practice | 8224351788 |
Receives reassigned benefits from 1 practitioner Practice locations: Fort Worth, TX |
National Provider Directory
Locations
5007 Summerville Rd
Phenix City, AL 36867
Phone (334) 323-3937
100 Bascom Ct
Columbus, GA 31909
Phone (706) 350-5800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | AL | Yes |
Addresses
Primary practice location
5007 Summerville Road
Phenix City, AL 36867-1559
Mailing address
PO Box 242848
Montgomery, AL 36124-2848
Phone (334) 386-9357
Other providers in Phenix City, AL
- Bill G Berryman
- Bi-City Medical Ministries, Inc.
- Brandy Bratcher Bickley
- Muneerah Shabazz Bonner
- Linda Sue Borkat
- Bridgeway Health and Rehabilitation Center LLC
- Keanthony Darnell Brooks
- Briana Brown
- Justin Jamal Anthony Brown
- Natalie Brown
All providers in Phenix City, AL · Diagnostic Radiology Physician in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.