Biostat Imaging

Primary specialty

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

Legal business name

BIOSTAT IMAGING

Practice address

6210 N Belt Line Rd Ste 170
Irving, TX 75063-2681

Phone

(469) 848-7376

Fax

(214) 261-5155

NPI assigned

Oct 7, 2019

Last updated

Jan 24, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James Dieter

Title

Ceo

Phone

(832) 524-5355

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1528609997. Details of each certification follow.

• CCN 45X0009930 Portable X-ray supplier · Active · Name & address match · Details

Portable X-ray supplier certification: CCN 45X0009930

Legal name

BIOSTAT IMAGING

Certification status

Active

Provider type (POS)

Portable X-ray supplier

Participating since

Apr 19, 2022

Last certification

Apr 19, 2022

Ownership / control type

Individual

Most recent change of ownership

Jul 31, 2024

Facility address

6210 N Belt Line Rd Ste 170
Irving, TX 75063

Locations

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

{
    "created_epoch": "1570406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737676800000",
    "number": "1528609997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16840 BUCCANEER LN STE 261",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770582570",
            "telephone_number": "469-848-7376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6210 N BELT LINE RD STE 170",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750632681",
            "telephone_number": "469-848-7376",
            "fax_number": "214-261-5155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIOSTAT IMAGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-07",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A",
        "authorized_official_last_name": "DIETER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "832-524-5355"
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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": []
}

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• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Irving, TX
• Providers in Irving, TX by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.