Medical Diagnostic Imaging LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

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

Last updated

Feb 5, 2021By 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

Pamela Carlsen

Title

Director of Business Development

Phone

(414) 282-4100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, CT, WI, MP, CA, FL6 enrollments

Enrollment records 6

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 38

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.

• Eric Michael Blaschke, M.D.

  • Diagnostic Radiology Physician
  • Greenfield, WI
  • NPI 1386957678
  Medicare reassignment Care Compare group NPD
• Daniel C Bloomgarden, MD

  • Diagnostic Radiology Physician
  • Greenfield, WI
  • NPI 1821019639
  Medicare reassignment Care Compare group NPD
• Robert Gould, MD

  • Diagnostic Radiology Physician
  • Greenfield, WI
  • NPI 1669422713
  Medicare reassignment Care Compare group NPD
• Stephen J Handrich, MD

  • Diagnostic Radiology Physician
  • Greenfield, WI
  • NPI 1265454003
  Medicare reassignment Care Compare group NPD
• Shekhar S Sane, MD

  • Diagnostic Radiology Physician
  • Greenfield, WI
  • NPI 1740207711
  Medicare reassignment Care Compare group NPD
• Christopher Werner Grant, M.D.

  • Neuroradiology Physician
  • Chicago, IL
  • NPI 1114212040

  Diagnostic Radiology, WI

  Medicare reassignment Care Compare group NPD
• Sean Spencer London, MD

  • Body Imaging Physician
  • Northridge, CA
  • NPI 1043650443
  Medicare reassignment Care Compare group NPD
• Akash D. Shah, M.D.

  • Diagnostic Radiology Physician
  • Chicago, IL
  • NPI 1134338957

  WI

  Medicare reassignment Care Compare group NPD
• Sean R Amoli, MD

  • Diagnostic Radiology Physician
  • Milwaukee, WI
  • NPI 1295752251
  Medicare reassignment Care Compare group
• Amy Lynn Doherty, PA-C

  • Physician Assistant
  • Greenfield, WI
  • NPI 1649431255
  Medicare reassignment Care Compare group
• Krista M Kitzerow, PA-C

  • Physician Assistant
  • Milwaukee, WI
  • NPI 1619126968
  Medicare reassignment Care Compare group
• Deidre Meredith Rippl, M.D.

  • Diagnostic Radiology Physician
  • Milwaukee, WI
  • NPI 1598949026

  FL

  Medicare reassignment Care Compare group

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": [],
    "endpoints": [],
    "other_names": []
}

• Jamie McGuire, COTA
• Melissa D McGuire, APNP
• Terrence Patrick McGuire, PSY.D.
• Timothy J McNamara, DDS
• Abigail B. Meara, PA
• Martin J Medina, PA-C
• Meijer Stores Limited Partnership (Meijer Pharmacy #292)
• Yesenia Mendoza-Evangelista
• Patricia M Mendoza, APSW
• Jamie Azlyn Mengert, MOT

• Diagnostic Radiology Physician in Greenfield, WI
• Providers in Greenfield, WI by specialty
• Diagnostic Radiology Physician in Wisconsin

• 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.

Verify at the official NPI Registry.