Boise Imaging Solutions LLC

Primary specialty

Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X

Legal business name

BOISE IMAGING SOLUTIONS LLC

Doing business as

Pacific Mobile Diagnostics

Practice address

1351 W Pine Ave Ste a
Meridian, ID 83642-2010

Phone

(949) 487-9500

NPI assigned

Feb 5, 2024

Organization subpart

No

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

Authorized official

Name

Tangina Maloof

Title

Treasurer

Phone

(469) 636-5055

Specialties & licenses 1

Addresses

Other names 1

• Pacific Mobile Diagnostics Doing business as

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• Boise Imaging Solutions LLC

  dba Pacific Mobile Diagnostics

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Meridian, ID
  • NPI 1255185716

  7911349725

  Same PAC ID

Tax ID family

Boise Imaging Solutions LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Boise Imaging Solutions LLC

  dba Pacific Mobile Diagnostics

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Meridian, ID
  • NPI 1255185716
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Bakorp, L.L.C.

  dba Pacific Mobile Diagnostics

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • West Valley, UT
  • NPI 1679812440

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707091200000",
    "number": "1497518096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W BROADWAY RD STE 155",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852821138",
            "telephone_number": "949-487-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 W PINE AVE STE A",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422010",
            "telephone_number": "949-487-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOISE IMAGING SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A",
        "authorized_official_last_name": "MALOOF",
        "authorized_official_first_name": "TANGINA",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "469-636-5055"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Mobile Diagnostics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Boise Endoscopy Center, LLC (10 Mile Endoscopy Center)
• Boise Endoscopy Center, LLC (dba Meridian Endoscopy Center)
• Boise Id Caregiving LLC
• Boise Id Homecare
• Boise Imaging Solutions LLC (Pacific Mobile Diagnostics)
• Boise Intensive Care Hospital Inc (Complex Care Hosptial of Idaho)
• Boise Intensive Care Hospital, Inc. (Complex Care Hospital of Idaho)
• Boise Kidney & Hypertension PLLC
• Boise Naturopathic Medicine PC
• Boise Surgical Group

• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Meridian, ID
• Providers in Meridian, ID by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.