NPIMap

Organization Active NPI

Image Guided Therapeutics, Inc.

  • Diagnostic Radiology Physician
  • San Francisco, CA
National Provider Identifier
1316968910
Registry record updated Jul 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A83022 Issued in CA
Legal business name
IMAGE GUIDED THERAPEUTICS, INC.
Practice address
450 Stanyan St
San Francisco, CA 94117-1079
Phone
(415) 750-5770
NPI assigned
Jul 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2015

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

Authorized official

Name
Michael Taylor, M.D.NPI 1902892102
Title
Ceo
Phone
(415) 750-4916

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085B0100X A8300022 CA
Neuroradiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085N0700X A83022 CA
Nuclear Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085N0904X A83022 CA
Pediatric Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085P0229X A83022 CA
Diagnostic Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0202X A83022 CA Primary
Vascular & Interventional Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0204X A83022 CA
Diagnostic Ultrasound PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085U0001X A83022 CA

Addresses

Primary practice location

450 Stanyan St
San Francisco, CA 94117-1079

Mailing address

File 1687 1801 W Olympic Blvd
Pasadena, CA 91199-1687
Phone (855) 735-7720

Other identifiers 2

IdentifierTypeStateIssuer
GR0103430MedicaidCA
ZZZ03894ZOtherCAMEDICARE GROUP PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WA, UT, GA, FL5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
O20061122000480 CA Part B Supplier - Clinic/Group Practice 6608874896 Receives reassigned benefits from 15 practitioners
Practice locations: San Francisco, CA; Davis, CA; Redwood City, CA
O20210421001030 WA Part B Supplier - Clinic/Group Practice 6608874896 Receives reassigned benefits from 2 practitioners
Practice locations: Seattle, WA; Shoreline, WA
O20221227000047 UT Part B Supplier - Clinic/Group Practice 6608874896 Receives reassigned benefits from 1 practitioner
Practice locations: West Valley, UT
O20240605002338 GA Part B Supplier - Clinic/Group Practice 6608874896 Receives reassigned benefits from 1 practitioner
Practice locations: Atlanta, GA
O20240719000474 FL Part B Supplier - Clinic/Group Practice 6608874896 Receives reassigned benefits from 1 practitioner
Practice locations: Winter Park, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437350400000",
    "number": "1316968910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE 1687 1801 W OLYMPIC BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911991687",
            "telephone_number": "855-735-7720",
            "fax_number": "415-683-5591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 STANYAN ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941171079",
            "telephone_number": "415-750-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGE GUIDED THERAPEUTICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2015-07-20",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "415-750-4916",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Body Imaging",
            "state": "CA",
            "license": "A8300022",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Neuroradiology",
            "state": "CA",
            "license": "A83022",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Nuclear Radiology",
            "state": "CA",
            "license": "A83022",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Pediatric Radiology",
            "state": "CA",
            "license": "A83022",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A83022",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "A83022",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "CA",
            "license": "A83022",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0103430",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PROVIDER NUMBER",
            "identifier": "ZZZ03894Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; 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.