NPIMap

Organization Active NPI

Pleasanton Diagnostic Imaging, Inc.

  • Diagnostic Radiology Physician
  • Pleasanton, CA
National Provider Identifier
1386937191
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
PLEASANTON DIAGNOSTIC IMAGING, INC.
Practice address
5860 Owens Dr Ste 150
Pleasanton, CA 94588-3980
Phone
(925) 467-1400
Fax
(925) 467-1409
NPI assigned
May 26, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Authorized official

Name
Jaikumar Krishnaswamy
Title
Officer/Authorized Official
Phone
(972) 713-3500

Specialties & licenses 1

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

Addresses

Primary practice location

5860 Owens Dr Ste 150
Pleasanton, CA 94588-3980

Mailing address

5860 Owens Dr
Ste 150
Pleasanton, CA 94588-3900
Phone (925) 467-1400

Other practice location 1

4211 Rosewood Dr
Ste. 5
Pleasanton, CA 94588-3049
Phone (925) 467-1400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120321000827 CA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 3779743166 Practice locations: Pleasanton, CA

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Pleasanton Diagnostic Imaging2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Member of 4

Organizations this organization is a member of, according to the National Provider Directory.

Locations

File 749847
Los Angeles, CA 90074

Practitioners & affiliated clinicians

Practitioners 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724803200000",
    "number": "1386937191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5860 OWENS DR",
            "address_2": "STE 150",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945883900",
            "telephone_number": "925-467-1400",
            "fax_number": "925-467-1409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5860 OWENS DR STE 150",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945883980",
            "telephone_number": "925-467-1400",
            "fax_number": "925-467-1409"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4211 Rosewood Dr",
            "address_2": "Ste. 5",
            "address_purpose": "LOCATION",
            "city": "Pleasanton",
            "state": "CA",
            "postal_code": "945883049",
            "country_code": "US",
            "telephone_number": "925-467-1400",
            "fax_number": "925-467-1409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PLEASANTON DIAGNOSTIC IMAGING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-26",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A",
        "authorized_official_last_name": "KRISHNASWAMY",
        "authorized_official_first_name": "JAIKUMAR",
        "authorized_official_title_or_position": "OFFICER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "972-713-3500"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; 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.