NPIMap

Organization Active NPI

McMinnville Imaging Associates LLP

  • Diagnostic Radiology Physician
  • McMinnville, OR
National Provider Identifier
1477505501
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
09360 Issued in OR
Legal business name
MCMINNVILLE IMAGING ASSOCIATES LLP
Practice address
2700 SE Stratus Ave
McMinnville, OR 97128-6255
Phone
(503) 472-1104
NPI assigned
May 17, 2006
Last updated
Feb 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Authorized official

Name
Steven H Edelman, MDNPI 1093769390
Title
President
Phone
(503) 472-6620

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 09360 OR Primary

Addresses

Primary practice location

2700 SE Stratus Ave
McMinnville, OR 97128-6255

Mailing address

PO Box 516
Corvallis, OR 97339-0516
Phone (541) 758-5047

Other identifiers 1

IdentifierTypeStateIssuer
019117MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040407000880 OR Part B Supplier - Clinic/Group Practice 6507859279 Receives reassigned benefits from 2 practitioners
Practice locations: McMinnville, OR

National Provider Directory

National Provider Directory

Locations

2435 NE Cumulus Ave
McMinnville, OR 97128
Phone (503) 472-6161

325 NE Evans St
McMinnville, OR 97128
Phone (503) 472-1104

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677542400000",
    "number": "1477505501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 516",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973390516",
            "telephone_number": "541-758-5047",
            "fax_number": "541-758-3713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 SE STRATUS AVE",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971286255",
            "telephone_number": "503-472-1104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCMINNVILLE IMAGING ASSOCIATES LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A",
        "authorized_official_last_name": "EDELMAN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-472-6620",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "09360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019117",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McMinnville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; 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.