Elite Diagnostic Imaging LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

ELITE DIAGNOSTIC IMAGING LLC

Practice address

9758 E 21St St N Ste 103
Wichita, KS 67206-3201

Phone

(603) 264-8050

NPI assigned

Mar 21, 2025

Organization subpart

No

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

Authorized official

Name

Amela Deumic

Title

Billing Manager

Phone

(603) 264-8050

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Benjamin Ross Park, D.O.

  • Diagnostic Radiology Physician
  • Bothell, WA
  • NPI 1770922676
  NPD

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

{
    "created_epoch": "1742515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742515200000",
    "number": "1427859800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9758 E 21ST ST N STE 103",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9758 E 21ST ST N STE 103",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063201",
            "telephone_number": "603-264-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE DIAGNOSTIC IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-21",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A",
        "authorized_official_last_name": "DEUMIC",
        "authorized_official_first_name": "AMELA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "603-264-8050"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Yvonne Elias-Moussa, PHARMACIST
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• Elite Home Care LLC
• Elite Physical Therapy
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• John Eliveha, M.D.

• Diagnostic Radiology Physician in Wichita, KS
• Providers in Wichita, KS by specialty
• Diagnostic Radiology Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.