NPIMap

Organization Active NPI

Meriden Imaging Center, Inc.

  • Diagnostic Radiology Physician
  • Wallingford, CT
National Provider Identifier
1508812561
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
MERIDEN IMAGING CENTER, INC.
Practice address
863 N Main Street Ext
Wallingford, CT 06492-2434
Phone
(203) 294-2721
Fax
(203) 949-2712
NPI assigned
May 25, 2006
Last updated
Aug 13, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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

Authorized official

Name
Gary Dee, MDNPI 1629052519
Title
Owner
Phone
(203) 949-2700

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU
Family Nurse Practitioner 363LF0000X NU
Diagnostic Radiology Physician 2085R0202X NU Primary
Vascular & Interventional Radiology Physician 2085R0204X NU

Addresses

Primary practice location

863 N Main Street Ext
Wallingford, CT 06492-2434

Mailing address

101 N Plains Industrial Rd
Wallingford, CT 06492-2360
Phone (203) 949-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, CA, KS3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20050427000621 CT Part B Supplier - Clinic/Group Practice 4385683556 Receives reassigned benefits from 107 practitioners
Practice locations: Cheshire, CT; West Hartford, CT; Wallingford, CT; Vernon, CT; South Windsor, CT; Plainville, CT; New Britain, CT; Mystic, CT…
O20260130003292 CA Part B Supplier - Clinic/Group Practice 4385683556 Receives reassigned benefits from 10 practitioners
Practice locations: Huntington Beach, CA; Stockton, CA; San Marcos, CA; Irvine, CA; Coronado, CA; Claremont, CA; Carlsbad, CA; Burbank, CA…
O20260425000479 KS Part B Supplier - Clinic/Group Practice 4385683556 Receives reassigned benefits from 1 practitioner
Practice locations: Overland Park, KS

National Provider Directory

National Provider Directory

Locations

280 S Main St
Cheshire, CT 06410
Phone (203) 237-2477

565 Long Hill Rd
Groton, CT 06340
Phone (401) 596-5695

2200 Whitney Ave
Ste 120
Hamden, CT 06518
Phone (203) 230-3005

140 Main St
Ste 7
Middletown, CT 06457

100 Perkins Farm Dr
Ste 100
Mystic, CT 06355

100 Perkins Farm Dr
Ste 101
Mystic, CT 06355

97 Barnes Rd
Wallingford, CT 06492
Phone (203) 284-3137

Practitioners & affiliated clinicians

Practitioners 111

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.

View all 111

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565654400000",
    "number": "1508812561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N PLAINS INDUSTRIAL RD",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922360",
            "telephone_number": "203-949-2700",
            "fax_number": "203-949-2712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "863 N MAIN STREET EXT",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922434",
            "telephone_number": "203-294-2721",
            "fax_number": "203-949-2712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDEN IMAGING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2019-08-13",
        "status": "A",
        "authorized_official_last_name": "DEE",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-949-2700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; 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.