NPIMap

Organization Active NPI

Lumina Imaging

  • Diagnostic Radiology Physician
  • Mentor, OH
National Provider Identifier
1326645813
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
LUMINA IMAGING
Practice address
8401 Mentor Ave Ste B
Mentor, OH 44060-5843
Phone
(440) 592-6060
NPI assigned
Oct 7, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Authorized official

Name
Bryan Crowley
Title
Director Lumina Imaging
Phone
(440) 592-6109

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

8401 Mentor Ave Ste B
Mentor, OH 44060-5843

Mailing address

8401 Mentor Ave Ste B
Mentor, OH 44060-5843

Other practice location 1

30400 Detroit Rd Ste 101
Westlake, OH 44145-1855
Phone (440) 592-6065

Other practice location 2

3985 Medina Rd Ste 180
Medina, OH 44256-5968
Phone (440) 592-6085

Other practice location 3

5855 Harper Rd Ste A
Solon, OH 44139-1832
Phone (440) 592-6105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
O20210607001594 OH Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 0547660961 Practice locations: Mentor, OH
O20210607002369 OH Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 0547660961 Practice locations: Solon, OH
O20220301002661 OH Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 0547660961 Practice locations: Medina, OH
O20220818000923 OH Part B Supplier - Clinic/Group Practice 0547660961 Receives reassigned benefits from 55 practitioners
Practice locations: Mentor, OH
O20241002000765 OH Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 0547660961 Receives reassigned benefits from 1 practitioner
Practice locations: Westlake, OH

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

8401 Mentor Ave
Ste B
Mentor, OH 44060
Phone (440) 592-6095

5855 Harper Rd
Ste A
Solon, OH 44139
Phone (440) 498-5693

30400 Detroit Rd
Ste 101
Westlake, OH 44145
Phone (440) 592-6065

Practitioners & affiliated clinicians

Practitioners 67

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

View all 67

NPI Registry JSON

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

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695859200000",
    "number": "1326645813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 MENTOR AVE STE B",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440605843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 MENTOR AVE STE B",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440605843",
            "telephone_number": "440-592-6060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30400 Detroit Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Westlake",
            "state": "OH",
            "postal_code": "441451855",
            "country_code": "US",
            "telephone_number": "440-592-6065",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3985 Medina Rd Ste 180",
            "address_purpose": "LOCATION",
            "city": "Medina",
            "state": "OH",
            "postal_code": "442565968",
            "country_code": "US",
            "telephone_number": "440-592-6085",
            "fax_number": "216-957-8419",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5855 Harper Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Solon",
            "state": "OH",
            "postal_code": "441391832",
            "country_code": "US",
            "telephone_number": "440-592-6105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LUMINA IMAGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-07",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A",
        "authorized_official_last_name": "CROWLEY",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "DIRECTOR LUMINA IMAGING",
        "authorized_official_telephone_number": "440-592-6109"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; 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.