NPIMap

Organization Active NPI

Ambervale LLC

  • Radiology Clinic/Center
  • Fort Wayne, IN
National Provider Identifier
1487574604
Registry record updated Jul 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
AMBERVALE LLC
Practice address
5534 Saint Joe Rd
Fort Wayne, IN 46835-3328
Phone
(406) 309-6462
NPI assigned
Jul 17, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2026

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

Authorized official

Name
Samee Ijaz
Title
Owner
Phone
(406) 309-6462

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

5534 Saint Joe Rd
Fort Wayne, IN 46835-3328

Mailing address

5534 Saint Joe Rd
Fort Wayne, IN 46835-3328
Phone (406) 309-6462

National Provider Directory

National Provider Directory
Tax ID family
Ambervale LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1784246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784246400000",
    "number": "1487574604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5534 SAINT JOE RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468353328",
            "telephone_number": "406-309-6462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5534 SAINT JOE RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468353328",
            "telephone_number": "406-309-6462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBERVALE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-17",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A",
        "authorized_official_last_name": "IJAZ",
        "authorized_official_first_name": "SAMEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-309-6462"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2026; 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.