Individual provider Active NPI

Dmitriy Shlemanov, ARDMS

  • Sonography Radiologic Technologist
  • Westfield, MA
National Provider Identifier
1316299498
Registry record updated Oct 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sonography Radiologic TechnologistTaxonomy code 2471S1302X
License
93720 Issued in MA
Practice address
70 Court St. Same Day Ultrasound
Suite # 6
Westfield, MA 01085-3521
Phone
(413) 642-6373
NPI assigned
Oct 12, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sonography Radiologic Technologist 2471S1302X 93720 MA Primary
Vascular Sonography Radiologic Technologist 2471V0105X 93720 MA

Addresses

Primary practice location

70 Court St. Same Day Ultrasound
Suite # 6
Westfield, MA 01085-3521

Mailing address

70 Court St. Same Day Ultrasound
Suite # 6
Westfield, MA 01085-3521
Phone (413) 642-6373

Other identifiers 1

IdentifierTypeStateIssuer
N/AOtherMAN/A

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
93720MAMDVascular Sonography Radiologic Technologist

NPI Registry JSON

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

{
    "created_epoch": "1350000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350000000000",
    "number": "1316299498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 COURT ST. SAME DAY ULTRASOUND",
            "address_2": "SUITE # 6",
            "city": "WESTFIELD",
            "state": "MA",
            "postal_code": "010853521",
            "telephone_number": "413-642-6373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 COURT ST. SAME DAY ULTRASOUND",
            "address_2": "SUITE # 6",
            "city": "WESTFIELD",
            "state": "MA",
            "postal_code": "010853521",
            "telephone_number": "413-642-6373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHLEMANOV",
        "first_name": "DMITRIY",
        "credential": "ARDMS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-12",
        "last_updated": "2012-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471S1302X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Sonography",
            "state": "MA",
            "license": "93720",
            "primary": true
        },
        {
            "code": "2471V0105X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Vascular Sonography",
            "state": "MA",
            "license": "93720",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N/A",
            "identifier": "N/A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.