NPIMap

Organization Active NPI

Tristan Radiology Specialists, P.C.

  • Diagnostic Radiology Physician
  • Harrisburg, PA
National Provider Identifier
1366711673
Registry record updated Mar 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
TRISTAN RADIOLOGY SPECIALISTS, P.C.
Practice address
4518 Union Deposit Rd
Harrisburg, PA 17111-2921
Phone
(717) 652-5840
Fax
(717) 652-8152
NPI assigned
Dec 16, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2012

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

Authorized official

Name
Mr. Paul Deloia Jr.
Title
Ceo
Phone
(717) 652-6105

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X PA Primary

Addresses

Primary practice location

4518 Union Deposit Rd
Harrisburg, PA 17111-2921

Mailing address

4520 Union Deposit Rd
Harrisburg, PA 17111-2910
Phone (717) 652-6105

Other identifiers 1

IdentifierTypeStateIssuer
1026722000001MedicaidPA

National Provider Directory

National Provider Directory

Locations

5 Brookwood Ave
Carlisle, PA 17015
Phone (717) 243-2275

4700 Union Deposit Rd
Ste 1400
Harrisburg, PA 17111

8105 Adams Dr
Hummelstown, PA 17036
Phone (717) 230-3700

611 University Dr
Ste 115
State College, PA 16801

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1323993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330646400000",
    "number": "1366711673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4520 UNION DEPOSIT RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171112910",
            "telephone_number": "717-652-6105",
            "fax_number": "717-652-2165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4518 UNION DEPOSIT RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171112921",
            "telephone_number": "717-652-5840",
            "fax_number": "717-652-8152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRISTAN RADIOLOGY SPECIALISTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-16",
        "last_updated": "2012-03-02",
        "status": "A",
        "authorized_official_last_name": "DELOIA",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "717-652-6105",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1026722000001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2012; 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.