NPIMap

Organization Active NPI

Physician's Mobile X-Ray, Inc.

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Harrisburg, PA
National Provider Identifier
1316083595
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X
Legal business name
PHYSICIAN'S MOBILE X-RAY, INC.
Practice address
945 E Park Dr
Ste 102
Harrisburg, PA 17111-2804
Phone
(717) 561-4940
Fax
(717) 561-4999
NPI assigned
Jan 29, 2007
Last updated
Feb 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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

Authorized official

Name
Mr. Todd Gelbaugh
Title
Ceo
Phone
(717) 561-4940

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X PA Primary

Addresses

Primary practice location

945 E Park Dr
Ste 102
Harrisburg, PA 17111-2804

Mailing address

6310 Allentown Blvd Ste 102
Harrisburg, PA 17112-2739
Phone (717) 561-4940

Other identifiers 10

IdentifierTypeStateIssuer
1507996OtherPAGATEWAY PA MEDICAID
335685OtherPAADVANTRA
000000094397OtherPAUNISON HEALTH PLAN
000399807OtherPAHIGHMARK
1507996OtherPAGATEWAY MEDICARE ASSURED
441630015OtherPAUNITED HEALTHCARE RR MC
000138896OtherPAAPWU
000859039MedicaidPA
25-1352947OtherPACONTINENTAL GENERAL INS
25-1352947OtherPAUNITED HEALTHCARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041020000030 PA Part B Supplier - Portable X-Ray Supplier 0143281550 Practice locations: Harrisburg, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1316083595. Details of each certification follow.

Portable X-ray supplier certification: CCN 39X0009807

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
PHYSICIANS MOBILE X-RAY INC
Certification status
Active
Provider type (POS)
Portable X-ray supplier
Participating since
Dec 8, 1978
Last certification
Nov 25, 2025
Ownership / control type
Corporation
Facility address
945 East Park Drive
Harrisburg, PA 17111

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
Physician's Mobile X-Ray Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

1205 S 28th St
Harrisburg, PA 17111
Phone (717) 558-1000

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676851200000",
    "number": "1316083595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6310 ALLENTOWN BLVD STE 102",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171122739",
            "telephone_number": "717-561-4940",
            "fax_number": "717-561-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 E PARK DR",
            "address_2": "STE 102",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171112804",
            "telephone_number": "717-561-4940",
            "fax_number": "717-561-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN'S MOBILE X-RAY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A",
        "authorized_official_last_name": "GELBAUGH",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "717-561-4940",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY PA MEDICAID",
            "identifier": "1507996",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANTRA",
            "identifier": "335685",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON HEALTH PLAN",
            "identifier": "000000094397",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "000399807",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY MEDICARE ASSURED",
            "identifier": "1507996",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE RR MC",
            "identifier": "441630015",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APWU",
            "identifier": "000138896",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000859039",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTINENTAL GENERAL INS",
            "identifier": "25-1352947",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "25-1352947",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.