Imaging Specialists, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

IMAGING SPECIALISTS, LLC

Practice address

111 Northfield Ave Ste 207
West Orange, NJ 07052-4703

Phone

(800) 689-3275

NPI assigned

Aug 17, 2011

Last updated

Jan 15, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ketang Modi, DONPI 1396736468

Title

Managing Member

Phone

(201) 310-2957

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 4

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.

• Ketang Modi, D.O.

  • Diagnostic Radiology Physician
  • Hollywood, FL
  • NPI 1396736468

  NJ

  Medicare reassignment Care Compare group NPD Authorized official
• Jack Lawrence Baldassare, MD

  • Diagnostic Radiology Physician
  • Tenafly, NJ
  • NPI 1225070121
  Medicare reassignment Care Compare group NPD
• Terrance Lee, M.D.

  • Cardiovascular Disease Physician
  • Englewood Cliffs, NJ
  • NPI 1053350389
  NPD
• Salvatore Trazzera, MD

  • Cardiovascular Disease Physician
  • North Babylon, NY
  • NPI 1568469757
  NPD (past)

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

{
    "created_epoch": "1313539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705276800000",
    "number": "1346520715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 MORRIS AVE STE 204",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835914",
            "telephone_number": "201-310-2957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 NORTHFIELD AVE STE 207",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524703",
            "telephone_number": "800-689-3275"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "193 Palisade Ave",
            "address_purpose": "LOCATION",
            "city": "Jersey City",
            "state": "NJ",
            "postal_code": "073061112",
            "country_code": "US",
            "telephone_number": "201-656-4324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IMAGING SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-17",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A",
        "authorized_official_last_name": "MODI",
        "authorized_official_first_name": "KETANG",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "201-310-2957",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "227706",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "430293",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Radiology Clinic/Center in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Radiology Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2024; 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.