Organization Active NPI

Kent Diagnostic Radiology Associates PA

  • Diagnostic Radiology Physician
  • Dover, DE
National Provider Identifier
1417044298
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
KENT DIAGNOSTIC RADIOLOGY ASSOCIATES PA
Practice address
640 S State St
Dover, DE 19901-3530
Phone
(302) 674-2202
NPI assigned
Oct 5, 2006
Last updated
Oct 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Authorized official

Name
Jill Stiles
Title
Provider
Phone
(302) 744-6122

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

640 S State St
Dover, DE 19901-3530

Mailing address

PO Box 4238
Portsmouth, NH 03802-4238

Other names 1

  • KENT DIAGNOSTIC RADIOLOGY ASSOCIATE P A Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040504001264 DE Part B Supplier - Clinic/Group Practice 3971591371 Receives reassigned benefits from 17 practitioners
Practice locations: Dover, DE; Milford, DE; Milton, DE

National Provider Directory

National Provider Directory

Locations

8391 Beverly Blvd
Unit 264
Los Angeles, CA 90048
Phone (213) 247-7251

135 Commerce Way
Portsmouth, NH 03801

210 Commerce Way
Ste 100
Portsmouth, NH 03801

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696896000000",
    "number": "1417044298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4238",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038024238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 S STATE ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013530",
            "telephone_number": "302-674-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENT DIAGNOSTIC RADIOLOGY ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A",
        "authorized_official_last_name": "STILES",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "302-744-6122"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KENT DIAGNOSTIC RADIOLOGY ASSOCIATE P A",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dover, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.