Active NPI
Medical Diagnostic Imaging LLC
- Diagnostic Radiology Physician
- Greenfield, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- Legal business name
- MEDICAL DIAGNOSTIC IMAGING LLC
- Practice address
- 6150 W Layton Ave
Greenfield, WI 53220-4608 - Phone
- (414) 282-4100
- Fax
- (414) 282-4105
- NPI assigned
- Aug 24, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Pamela Carlsen
- Title
- Director of Business Development
- Phone
- (414) 282-4100
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | Primary |
Addresses
Primary practice location
6150 W Layton Ave
Greenfield, WI 53220-4608
Mailing address
6150 West Layton Ave
Greenfield, WI 53220
Phone (414) 282-4100
Other practice location 1
3111 W Rawson Ave
Franklin, WI 53132-9417
Phone (414) 282-4100
Other practice location 2
3077 N Mayfair Rd
Wauwatosa, WI 53222-4305
Phone (414) 282-4100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32896000 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, CT, WI, MP, CA, FL
Enrollment records 6
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D0990017 | Medical Diagnostic Imaging LLC | Certificate of waiver | Jan 15, 2027 |
| 52D2006919 | Medical Diagnostic Imaging | Certificate of waiver | May 3, 2028 |
National Provider Directory
National Provider DirectoryLocations
3111 W Rawson Ave
Ste 105
Franklin, WI 53132
Phone (414) 301-4500
6150 W Layton Ave
Ste 110
Greenfield, WI 53220
Phone (414) 761-8346
6150 W Layton Ave
Ste 106
Greenfield, WI 53220
6150 W Layton Ave
#106
Greenfield, WI 53220
8522 W Capitol Dr
Milwaukee, WI 53222
Phone (262) 573-0172
6150 W Layton Ave
Milwaukee, WI 53220
3077 N Mayfair Rd
Ste 115
Wauwatosa, WI 53222
Phone (414) 847-1800
Practitioners & affiliated clinicians
Practitioners 37
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Diagnostic Radiology Physician
- Greenfield, WI
- NPI 1386957678
Diagnostic Radiology, WI
-
- Diagnostic Radiology Physician
- Greenfield, WI
- NPI 1821019639
Diagnostic Radiology, WI
-
- Neuroradiology Physician
- Chicago, IL
- NPI 1114212040
Diagnostic Radiology, IL, WI
-
- Diagnostic Radiology Physician
- Chicago, IL
- NPI 1134338957
Diagnostic Radiology, IL, WI
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1612483200000",
"number": "1427165331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6150 WEST LAYTON AVE",
"city": "GREENFIELD",
"state": "WI",
"postal_code": "53220",
"telephone_number": "414-282-4100",
"fax_number": "414-282-4108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6150 W LAYTON AVE",
"city": "GREENFIELD",
"state": "WI",
"postal_code": "532204608",
"telephone_number": "414-282-4100",
"fax_number": "414-282-4105"
}
],
"practiceLocations": [
{
"address_1": "3111 W Rawson Ave",
"address_purpose": "LOCATION",
"city": "Franklin",
"state": "WI",
"postal_code": "531329417",
"country_code": "US",
"telephone_number": "414-282-4100",
"fax_number": "414-282-4105",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3077 N Mayfair Rd",
"address_purpose": "LOCATION",
"city": "Wauwatosa",
"state": "WI",
"postal_code": "532224305",
"country_code": "US",
"telephone_number": "414-282-4100",
"fax_number": "414-282-4105",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "MEDICAL DIAGNOSTIC IMAGING LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-24",
"last_updated": "2021-02-05",
"certification_date": "2021-02-05",
"status": "A",
"authorized_official_last_name": "CARLSEN",
"authorized_official_first_name": "PAMELA",
"authorized_official_title_or_position": "DIRECTOR OF BUSINESS DEVELOPMENT",
"authorized_official_telephone_number": "414-282-4100"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "32896000",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.