Radiology Associates PA
Organization Active NPI Diagnostic Radiology Physician · Little Rock, AR
NPI 1366438186 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1366438186
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- MC0023 (AR)
- Legal business name
- RADIOLOGY ASSOCIATES PA
- Practice address
- 500 S University Ave
Suite 101
Little Rock, AR 72205-5302 - Phone
- (501) 664-3914
- Fax
- (501) 664-5246
- NPI assigned
- Sep 27, 2005
- Organization subpart
- No
Authorized official
- Name
- Mr. Jerry W Linebarger
- Title
- Chief Administrative Officer
- Phone
- (501) 664-3914
Member organizations 1
Practitioners 135
-
Edward E Angtuaco, M.D.
-
Jodi M Barboza, MD
-
William J Borror, M.D.
-
Eric R Bready, MD
-
Douglas E. Elliott, M.D.
-
Michael Lawrence Flick, M.D.
-
Micah Ryan Fritsche, M.D.
-
Aaron L. Janos, M.D.
-
Paige Johnson, MD
-
Brandon M. Kelly, MD
-
Paolo P. Lim, M.D.
-
Ethan P McMoran, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 04D1044895 | Radiology Associates PA | Certificate of waiver | Feb 16, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (8 enrollments) in AR, CO, WA, FL, CA, OK, NY, TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040421001682 | AR | Part B Supplier - Clinic/Group Practice | 7517953912 |
Receives reassigned benefits from 49 practitioners Practice locations: Little Rock, AR |
| O20200302001508 | CO | Part B Supplier - Clinic/Group Practice | 7517953912 |
Receives reassigned benefits from 3 practitioners Practice locations: Superior, CO |
| O20200713001634 | WA | Part B Supplier - Clinic/Group Practice | 7517953912 |
Receives reassigned benefits from 58 practitioners Practice locations: Edmonds, WA |
| O20210318000253 | FL | Part B Supplier - Clinic/Group Practice | 7517953912 |
Receives reassigned benefits from 5 practitioners Practice locations: Osprey, FL |
| O20211021002791 | CA | Part B Supplier - Clinic/Group Practice | 7517953912 |
Receives reassigned benefits from 5 practitioners Practice locations: El Cajon, CA; Huntington Beach, CA |
| O20230621000208 | OK | Part B Supplier - Clinic/Group Practice | 7517953912 |
Receives reassigned benefits from 4 practitioners Practice locations: Oklahoma City, OK |
| O20241025000848 | NY | Part B Supplier - Clinic/Group Practice | 7517953912 |
Receives reassigned benefits from 2 practitioners Practice locations: Brooklyn, NY |
| O20241121001451 | TX | Part B Supplier - Clinic/Group Practice | 7517953912 |
Receives reassigned benefits from 6 practitioners Practice locations: Lewisville, TX |
National Provider Directory
Locations
500 S University Ave
Ste 604
Little Rock, AR 72205
500 S University Ave
Ste 600
Little Rock, AR 72205
Phone (501) 686-2688
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | MC0023 | AR | Yes |
Addresses
Primary practice location
500 S University Ave
Suite 101
Little Rock, AR 72205-5302
Mailing address
500 S University Ave
Suite 101
Little Rock, AR 72205-5302
Phone (501) 664-3914
Other providers in Little Rock, AR
- Shrinivas Radder
- Cacee V Raddle
- Janet Susan Rader
- Radiant Vibe Wellness Spa LLC
- Radiation Oncology Associates PA
- Radiology Consultants of Little Rock, PA
- Claudia Elizabeth Raffo
- David Kibwe Raggay
- Deepa Raghavan
- Rhodora Amalian Raghavan
All providers in Little Rock, AR · Diagnostic Radiology Physician in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.