NPIMap

Organization Active NPI

Guam X-Ray

Doing business as Guam Radiology Consultants

  • Vascular & Interventional Radiology Physician
  • Tamuning, GU
National Provider Identifier
1376767426
Registry record updated May 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
GUAM X-RAY
Doing business as
Guam Radiology Consultants
Practice address
633 Gov Carlos G Camacho Rd
Guam Medical Plaza, Suite 210
Tamuning, GU 96913
Phone
(671) 649-1001
Fax
(671) 649-1002
NPI assigned
Apr 12, 2007
Last updated
May 15, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2018

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

Authorized official

Name
Mr. Nathaniel Benjamin Berg, M.D.NPI 1265646806
Title
Owner
Phone
(671) 649-1001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU
Vascular & Interventional Radiology Physician 2085R0204X NU Primary
Interventional Pain Medicine Physician 208VP0014X NU

Addresses

Primary practice location

633 Gov Carlos G Camacho Rd
Guam Medical Plaza, Suite 210
Tamuning, GU 96913

Mailing address

633 Governor Carlos G. Camacho Road
Guam Medical Plaza, Suite 210
Tamuning, GU 96913-3194
Phone (671) 649-1001

Other names 1

  • Guam Radiology Consultants Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210325002365 GU Part B Supplier - Clinic/Group Practice 8123180742 Receives reassigned benefits from 106 practitioners
Practice locations: Tamuning, GU

National Provider Directory

National Provider Directory

Locations

633 Gov Carlos G Camacho Rd
Tamuning, GU 96913
Phone (671) 646-6610

633 Gov Carlos G Camacho Rd
Ste 210
Tamuning, GU 96913
Phone (671) 649-1001

Practitioners & affiliated clinicians

Practitioners 118

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.

View all 118

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526342400000",
    "number": "1376767426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 GOVERNOR CARLOS G. CAMACHO ROAD",
            "address_2": "GUAM MEDICAL PLAZA, SUITE 210",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133194",
            "telephone_number": "671-649-1001",
            "fax_number": "671-649-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 GOV CARLOS G CAMACHO RD",
            "address_2": "GUAM MEDICAL PLAZA, SUITE 210",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "96913",
            "telephone_number": "671-649-1001",
            "fax_number": "671-649-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUAM X-RAY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2018-05-15",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "NATHANIEL",
        "authorized_official_middle_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "671-649-1001",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Guam Radiology Consultants",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Guam Radiology Consultants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tamuning, GU

Sources for this page

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