NPIMap

Organization Active NPI

Thousand Oaks Diagnostic Imaging Center

Doing business as Conejo Medical Magnetic Resonance Systems

  • Diagnostic Radiology Physician
  • Thousand Oaks, CA
National Provider Identifier
1437127693
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
THOUSAND OAKS DIAGNOSTIC IMAGING CENTER
Doing business as
Conejo Medical Magnetic Resonance Systems
Practice address
2180 Lynn Road
Thousand Oaks, CA 91360
Phone
(805) 495-9442
Fax
(805) 496-6695
NPI assigned
Mar 14, 2006
Organization subpart
Yes
Parent organization
THOUSAND OAKS DIAGNOSTIC IMAGING CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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

Authorized official

Name
Dr. Barry D Klein, MDNPI 1073585212
Title
Managing Partner
Phone
(805) 496-7755

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

2180 Lynn Road
Thousand Oaks, CA 91360

Mailing address

PO Box 51038
Los Angeles, CA 90051-5338
Phone (800) 210-0857

Other names 1

  • Conejo Medical Magnetic Resonance Systems Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091020000259 CA Part B Supplier - Clinic/Group Practice 6305983669 Receives reassigned benefits from 11 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Thousand Oaks, CA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Thousand Oaks Diagnostic Imaging Center2 organizations share this tax ID, including this one
Part of
Thousand Oaks Diagnostic Imaging Center

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2180 Lynn Rd
Thousand Oaks, CA 91360
Phone (805) 495-9442

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659312000000",
    "number": "1437127693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51038",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900515338",
            "telephone_number": "800-210-0857",
            "fax_number": "805-375-8903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 LYNN ROAD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "91360",
            "telephone_number": "805-495-9442",
            "fax_number": "805-496-6695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOUSAND OAKS DIAGNOSTIC IMAGING CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THOUSAND OAKS DIAGNOSTIC IMAGING CENTER",
        "enumeration_date": "2006-03-14",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "805-496-7755",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Conejo Medical Magnetic Resonance Systems",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Conejo Medical Magnetic Resonance Systems",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; 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.