NPIMap

Organization Active NPI

Medical Diagnostic Services Inc

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Indianapolis, IN
National Provider Identifier
1487816641
Registry record updated Jun 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X
Legal business name
MEDICAL DIAGNOSTIC SERVICES INC
Practice address
8007 S Meridian St
Ste 2C
Indianapolis, IN 46217-2901
Phone
(317) 881-9600
Fax
(317) 881-9605
NPI assigned
Jun 30, 2008
Organization subpart
Yes
Parent organization
MEDICAL DIAGNOSTIC SERVICES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 14, 2018

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

Authorized official

Name
Shams U. Siddiqui
Title
President
Phone
(847) 626-0800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X Primary

Addresses

Primary practice location

8007 S Meridian St
Ste 2C
Indianapolis, IN 46217-2901

Mailing address

3701 Jarvis Ave
Skokie, IL 60076-4019
Phone (847) 626-0800

Other identifiers 3

IdentifierTypeStateIssuer
200887330MedicaidIN
P00444793OtherINRAILROAD MEDICARE PIN
1487816641OtherINANTHEM BLUE CROSS BLUE SHIELD PIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070608000041 IN Part B Supplier - Portable X-Ray Supplier 5890893275 1 other NPI on this enrollment
Practice locations: Indianapolis, IN

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Medical Diag Services Inc6 organizations share this tax ID, including this one
Part of
Medical Diag Services Inc

Other organizations with this tax ID 5

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": "1214784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528934400000",
    "number": "1487816641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 JARVIS AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600764019",
            "telephone_number": "847-626-0800",
            "fax_number": "847-626-0819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8007 S MERIDIAN ST",
            "address_2": "STE 2C",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462172901",
            "telephone_number": "317-881-9600",
            "fax_number": "317-881-9605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL DIAGNOSTIC SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDICAL DIAGNOSTIC SERVICES INC",
        "enumeration_date": "2008-06-30",
        "last_updated": "2018-06-14",
        "status": "A",
        "authorized_official_last_name": "SIDDIQUI",
        "authorized_official_first_name": "SHAMS",
        "authorized_official_middle_name": "U.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-626-0800"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200887330",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00444793",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SHIELD PIN",
            "identifier": "1487816641",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2018; 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.