NPIMap

Organization Active NPI

Professional Portable Radiologic Services, Inc.

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Randolph, NJ
National Provider Identifier
1336716075
Registry record updated Mar 31, 2025
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
PROFESSIONAL PORTABLE RADIOLOGIC SERVICES, INC.
Practice address
540 State Route 10 Ste 1
Randolph, NJ 07869-2033
Phone
(866) 895-2119
Fax
(952) 915-9597
NPI assigned
Jun 10, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Authorized official

Name
Bruce Allen Johnson
Title
VP - Ao
Phone
(303) 589-4149

Specialties & licenses 1

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

Addresses

Primary practice location

540 State Route 10 Ste 1
Randolph, NJ 07869-2033

Mailing address

755 Cliff Rd E
Burnsville, MN 55337-1545
Phone (952) 915-9779

Other names 2

  • Professional Portable X-ray Doing business as
  • PPX Other name

National Provider Directory

National Provider Directory
Tax ID family
Professional Portable Radiologic Services Inc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

50 Tice Blvd
Ste A35
Woodcliff Lk, NJ 07677
Phone (201) 882-7526

NPI Registry JSON

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743379200000",
    "number": "1336716075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 CLIFF RD E",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553371545",
            "telephone_number": "952-915-9779",
            "fax_number": "952-915-9597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 STATE ROUTE 10 STE 1",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078692033",
            "telephone_number": "866-895-2119",
            "fax_number": "952-915-9597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PORTABLE RADIOLOGIC SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-10",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "VP - AO",
        "authorized_official_telephone_number": "303-589-4149"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Portable X-ray",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Professional Portable X-ray",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PPX",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Randolph, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; 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.