Mobilerad, Inc.

Primary specialty

Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X

License

51023476 Issued in NY

Legal business name

MOBILERAD, INC.

Practice address

27 Timberline Cir # CL
Port Jefferson, NY 11777-1440

Phone

(631) 642-2240

Fax

(631) 331-9868

NPI assigned

Jan 18, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Jamie Arthur Kircher Sr.

Title

Ceo

Phone

(631) 642-2240

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1200614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245024000000",
    "number": "1356527436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 708",
            "city": "MOUNT SINAI",
            "state": "NY",
            "postal_code": "117660708",
            "telephone_number": "631-642-2240",
            "fax_number": "631-331-9868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 TIMBERLINE CIR # CL",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771440",
            "telephone_number": "631-642-2240",
            "fax_number": "631-331-9868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILERAD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-18",
        "last_updated": "2009-06-15",
        "status": "A",
        "authorized_official_last_name": "KIRCHER",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "ARTHUR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "631-642-2240",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "NY",
            "license": "51023476",
            "primary": true
        },
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "NY",
            "license": "51023476",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02935037",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02333842",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mobile Radiology Clinic/Center in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Mobile Radiology Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2009; 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.