Radiology Regional Center P a

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

RADIOLOGY REGIONAL CENTER P A

Practice address

14551 Hope Center Loop
Fort Myers, FL 33912-4704

Phone

(239) 936-2316

Fax

(239) 936-3099

NPI assigned

May 19, 2006

Last updated

Oct 5, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tracy Prince

Title

Director

Phone

(480) 594-3884

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL, PR, MI, VA, CO, NY, TX, NC, TN, CA, WI, KY, SC, AZ, MA, UT, VI, DE, MD, IL, NJ21 enrollments

Enrollment records 21

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• RRC Vascular Specialists Inc

  • Vascular & Interventional Radiology Physician
  • Fort Myers, FL
  • NPI 1871778894

  Member Of

  NPD member

Locations

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

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.

• Mahogany Jervon Ambrose, M.D.

  • Diagnostic Radiology Physician
  • Fort Myers, FL
  • NPI 1316300940

  VI

  Medicare reassignment Care Compare group NPD
• Gregory Arov, DO

  • Diagnostic Radiology Physician
  • Arcadia, FL
  • NPI 1699003764
  Medicare reassignment Care Compare group NPD
• Surita Banerjee, MD

  • Diagnostic Radiology Physician
  • Fort Myers, FL
  • NPI 1740899939
  Medicare reassignment Care Compare group NPD
• Juan Carlos Batlle, MD

  • Diagnostic Radiology Physician
  • Miami, FL
  • NPI 1538130588

  CO

  Medicare reassignment Care Compare group NPD
• Stuart A Bobman, MD

  • Diagnostic Radiology Physician
  • Fort Myers, FL
  • NPI 1003853250
  Medicare reassignment Care Compare group NPD
• Ranjit Kumar Chaudhary, MBBS

  • Diagnostic Radiology Physician
  • Fort Myers, FL
  • NPI 1437704608
  Medicare reassignment Care Compare group NPD
• Edward J Danehy, MD

  • Diagnostic Radiology Physician
  • Fort Myers, FL
  • NPI 1891749008
  Medicare reassignment Care Compare group NPD
• Thomas Anderson Elkins, D.O.

  • Diagnostic Radiology Physician
  • Fort Myers, FL
  • NPI 1033552880
  Medicare reassignment Care Compare group NPD
• Yamil David Fourzali Sabbag, M.D.

  • Nuclear Medicine Physician
  • Fort Myers, FL
  • NPI 1881876936
  Medicare reassignment Care Compare group NPD
• Grygori Gerasymchuk, M.D.

  • Diagnostic Radiology Physician
  • Fort Myers, FL
  • NPI 1598974933

  MI

  Medicare reassignment Care Compare group NPD
• Glenn Edward Groat, M.D.

  • Diagnostic Radiology Physician
  • Fort Myers, FL
  • NPI 1538363080
  Medicare reassignment Care Compare group NPD
• Jason D Hamilton, M.D.

  • Diagnostic Radiology Physician
  • Fort Myers, FL
  • NPI 1437141926
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791158400000",
    "number": "1407809262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3660 BROADWAY",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339018005",
            "telephone_number": "239-936-2316",
            "fax_number": "239-834-6106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14551 HOPE CENTER LOOP",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124704",
            "telephone_number": "239-936-2316",
            "fax_number": "239-936-3099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 Del Prado Blvd S Ste 420",
            "address_purpose": "LOCATION",
            "city": "Cape Coral",
            "state": "FL",
            "postal_code": "339904698",
            "country_code": "US",
            "telephone_number": "239-936-2316",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6140 Winkler Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339198188",
            "country_code": "US",
            "telephone_number": "239-936-2316",
            "fax_number": "239-936-3099",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1110 Lee Blvd",
            "address_purpose": "LOCATION",
            "city": "Lehigh Acres",
            "state": "FL",
            "postal_code": "339364844",
            "country_code": "US",
            "telephone_number": "239-936-2316",
            "fax_number": "239-936-3099",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6100 Winkler Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339198126",
            "country_code": "US",
            "telephone_number": "239-936-2316",
            "fax_number": "239-936-3099",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1708 Cape Coral Pkwy W Ste 3",
            "address_purpose": "LOCATION",
            "city": "Cape Coral",
            "state": "FL",
            "postal_code": "339146985",
            "country_code": "US",
            "telephone_number": "239-936-2316",
            "fax_number": "239-936-3099",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1875 Veterans Park Dr Ste 2101",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341090596",
            "country_code": "US",
            "telephone_number": "239-936-2316",
            "fax_number": "239-936-3099",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6600 University Pkwy Ste 102",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342409040",
            "country_code": "US",
            "telephone_number": "239-936-2316",
            "fax_number": "239-936-3099",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18300 Murdock Cir Unit 101",
            "address_purpose": "LOCATION",
            "city": "Port Charlotte",
            "state": "FL",
            "postal_code": "339481116",
            "country_code": "US",
            "telephone_number": "239-936-2316",
            "fax_number": "239-936-3099",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10201 Arcos Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Estero",
            "state": "FL",
            "postal_code": "339289460",
            "country_code": "US",
            "telephone_number": "239-936-2316",
            "fax_number": "239-936-3099",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 Goodlette Rd",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341025644",
            "country_code": "US",
            "telephone_number": "239-936-2316",
            "fax_number": "239-936-3099",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "805 Del Prado Blvd S",
            "address_purpose": "LOCATION",
            "city": "Cape Coral",
            "state": "FL",
            "postal_code": "339902666",
            "country_code": "US",
            "telephone_number": "239-936-2316",
            "fax_number": "239-936-3099",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9776 Bonita Beach Rd SE Ste 101A",
            "address_purpose": "LOCATION",
            "city": "Bonita Springs",
            "state": "FL",
            "postal_code": "341354773",
            "country_code": "US",
            "telephone_number": "239-936-2316",
            "fax_number": "239-936-3099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RADIOLOGY REGIONAL CENTER P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2026-10-05",
        "certification_date": "2026-10-05",
        "status": "A",
        "authorized_official_last_name": "PRINCE",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "480-594-3884"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "054636401",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alex David Rade Moreno I, RBT
• Melanie D Rader
• Radiology Associates of Tampa PA
• Radiology Imaging Specialists LLC (Carefirst Imaging)
• Radiology of MSMC, LLC
• Radiology Regional Center Professional Services LLC
• Radiology Regional Center, PA
• Radiology Regional Center, PA
• Radiology Regional Center, PA
• Michele Rae Childers Skrmetta, LMHC

• Diagnostic Radiology Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Diagnostic Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2026; 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.