NPIMap

Organization Active NPI

Advanced Radiology P a

  • Diagnostic Radiology Physician
  • Baltimore, MD
National Provider Identifier
1457178337
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
ADVANCED RADIOLOGY P A
Practice address
3700 Fleet St Ste 110
Baltimore, MD 21224-4238
Phone
(888) 972-9700
Fax
(410) 918-3425
NPI assigned
Sep 23, 2024
Organization subpart
Yes
Parent organization
ADVANCED RADIOLOGY P AAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Authorized official

Name
David I Safferman
Title
President & Ceo
Phone
(443) 436-1116

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207U00000X
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X

Addresses

Primary practice location

3700 Fleet St Ste 110
Baltimore, MD 21224-4238

Mailing address

10461 Mill Run Cir Ste 1020
Owings Mills, MD 21117-5544
Phone (443) 436-1221

Other names 1

  • ADV - Fleet Street Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040420001334 MD Part B Supplier - Clinic/Group Practice 1254327950 Receives reassigned benefits from 133 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Anant Kusakull52 organizations share this tax ID, including this one
Part of
Anant Kusakull

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

3700 Fleet St
Ste 110
Baltimore, MD 21224
Phone (443) 663-2200

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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": "1727049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727049600000",
    "number": "1457178337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10461 MILL RUN CIR STE 1020",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175544",
            "telephone_number": "443-436-1221",
            "fax_number": "443-436-1256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 FLEET ST STE 110",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212244238",
            "telephone_number": "888-972-9700",
            "fax_number": "410-918-3425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED RADIOLOGY P A",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVANCED RADIOLOGY P A",
        "enumeration_date": "2024-09-23",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A",
        "authorized_official_last_name": "SAFFERMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "443-436-1116"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ADV - Fleet Street",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; 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.