Open and Wide MRI LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

OPEN AND WIDE MRI LLC

Practice address

3050 Windsor Court
Elkhart, IN 46514-5555

Phone

(574) 266-9222

NPI assigned

Jun 2, 2006

Organization subpart

No

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

Authorized official

Name

Gardner Bartrom

Title

President

Phone

(765) 228-4660

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Open and Wide MRI LLC

  • Diagnostic Radiology Physician
  • Goshen, IN
  • NPI 1235185513

  O20040903000281

  Same enrollment

Tax ID family

Open and Wide MRI2 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.

• Open and Wide MRI, LLC

  • Magnetic Resonance Imaging Radiologic Technologist
  • Elkhart, IN
  • NPI 1558346148
  NPD tax ID

Practitioners 8

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

• Adel Abdalla, M.D.

  • Diagnostic Radiology Physician
  • Orlando, FL
  • NPI 1497702542

  IN

  Medicare reassignment Care Compare group NPD
• Philip B. McDonald, M.D.

  • Diagnostic Radiology Physician
  • Miami, FL
  • NPI 1649411422

  IN

  Medicare reassignment Care Compare group NPD
• Steven L Hossler, M.D.

  • Diagnostic Radiology Physician
  • Fort Wayne, IN
  • NPI 1124002746
  Medicare reassignment NPD
• Richard Lance Dejournett, M.D.

  • Diagnostic Radiology Physician
  • Honolulu, HI
  • NPI 1982691341
  NPD (past)
• Bryan Lee Kaufman, M.D.

  • Diagnostic Radiology Physician
  • Jacksonville, FL
  • NPI 1881691764
  NPD (past)
• Steven Harris Millmond, MD

  • Diagnostic Radiology Physician
  • Glendale, AZ
  • NPI 1851365944
  NPD (past)
• Roberto Rivera-Morales, MD

  • Diagnostic Radiology Physician
  • Weston, FL
  • NPI 1992797377
  NPD (past)
• Ranjiv Kumar Saini, M.D.

  • Diagnostic Radiology Physician
  • Daniel Island, SC
  • NPI 1578670220
  NPD (past)

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704672000000",
    "number": "1306883616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 338",
            "city": "LA FONTAINE",
            "state": "IN",
            "postal_code": "469400338",
            "telephone_number": "765-228-4660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 WINDSOR COURT",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465145555",
            "telephone_number": "574-266-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN AND WIDE MRI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A",
        "authorized_official_last_name": "BARTROM",
        "authorized_official_first_name": "GARDNER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "765-228-4660"
    },
    "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": "200415560",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CK6657",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle M Olson, LCSW
• Tamara Clare Olson, FNP
• Samsteve B Ombat
• Vivian U Onunkwo, MD
• Eli Opacich, PHARMD
• Open and Wide MRI, LLC
• Optum Behavioral Care of Colorado, P.C. (Keys Counseling of Indiana)
• Oral Surgery Center of Elkhart, Inc
• Myrna P. Orbana, M.D.
• Melitza Ortega

• Diagnostic Radiology Physician in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Diagnostic Radiology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; 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.