NPIMap

Organization Active NPI

Medical Diagnostic Services Inc

  • Physiological Laboratory
  • Indianapolis, IN
National Provider Identifier
1376700088
Registry record updated Sep 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
MEDICAL DIAGNOSTIC SERVICES INC
Practice address
Medical Diagnostic Services Inc
8007 S Meridian St
Indianapolis, IN 46217-2901
Phone
(317) 881-9600
Fax
(317) 881-9605
NPI assigned
May 20, 2008
Last updated
Sep 28, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDICAL DIAGNOSTIC SERVICES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 28, 2018

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

Authorized official

Name
Mr. Shams U. Siddiqui
Title
President
Phone
(317) 881-9600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X Primary

Addresses

Primary practice location

Medical Diagnostic Services Inc
8007 S Meridian St
Indianapolis, IN 46217-2901

Mailing address

3701 Jarvis Ave
Skokie, IL 60076-4019
Phone (847) 626-0800

Other identifiers 1

IdentifierTypeStateIssuer
200911850AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080229000004 IN Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 5890893275 Practice locations: Indianapolis, IN

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Medical Diagnostic SVCS Inc6 organizations share this tax ID, including this one
Part of
Medical Diagnostic SVCS Inc

Other organizations with this tax ID 5

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

Locations

3944 W Rosemont Ave
Chicago, IL 60659
Phone (773) 539-9999

8007 S Meridian St
Indianapolis, IN 46217
Phone (317) 881-9600

9358 Calumet Ave
Munster, IN 46321
Phone (219) 836-1222

9358 Caluumet Ave
Munster, IN 46321
Phone (219) 836-1222

4479 Pontiac Lake Rd
Ste 1D
Waterford, MI 48328
Phone (248) 499-7618

4479 Pontiac Lake Rd
Ste 4479
Waterford, MI 48328
Phone (248) 499-7618

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538092800000",
    "number": "1376700088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 JARVIS AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600764019",
            "telephone_number": "847-626-0800",
            "fax_number": "847-626-0819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL DIAGNOSTIC SERVICES INC",
            "address_2": "8007 S MERIDIAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462172901",
            "telephone_number": "317-881-9600",
            "fax_number": "317-881-9605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL DIAGNOSTIC SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDICAL DIAGNOSTIC SERVICES INC",
        "enumeration_date": "2008-05-20",
        "last_updated": "2018-09-28",
        "status": "A",
        "authorized_official_last_name": "SIDDIQUI",
        "authorized_official_first_name": "SHAMS",
        "authorized_official_middle_name": "U.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-881-9600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200911850A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2018; 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.