Daniel Eastlack

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

42401 Issued in AL

Practice address

7600 Wolf River Blvd Ste 200
Germantown, TN 38138-1788

Phone

(901) 747-1000

NPI assigned

May 3, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AR, AL, MS, TN4 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 4

Specialty

Diagnostic Radiology

Education

University of Tennessee, HSC, College of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Arkansas Clinic Charitable Foundation, Inc.Group PAC ID 2961547526, 294 clinicians

Mid-South Imaging and Therapeutics, P.a.Group PAC ID 9133106396, 69 clinicians

West Tennessee Imaging LLCGroup PAC ID 3173834215, 37 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048
• Baptist Memorial Hospital Desoto Hospital, Southaven, MS, CCN 250141
• Baptist Memorial Hospital Jonesboro, Inc. Hospital, Jonesboro, AR, CCN 040118
• Baptist Memorial Hospital Tipton Hospital, Covington, TN, CCN 440131
• Baptist Memorial Hospital Union City Hospital, Union City, TN, CCN 440130

Merit-based Incentive Payment System (MIPS)

Final score

75.65 of 100Reported as group

Quality

44.87

Promoting interoperability

100

Improvement activities

40

Cost

73.98

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• West Tennessee Imaging, LLC

  • Diagnostic Radiology Physician
  • Germantown, TN
  • NPI 1912395708

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Northeast Arkansas Clinic Charitable Foundation, Inc.

  • Multi-Specialty Clinic/Center
  • Jonesboro, AR
  • NPI 1861721839
  Medicare reassignment Care Compare group NPD
• Mid-South Imaging & Therapeutics, P.a.

  • Diagnostic Radiology Physician
  • Germantown, TN
  • NPI 1043260763

  AR, MS

  Medicare reassignment Care Compare group
• University of Alabama Health Services Foundation, PC.

  • Multi-Specialty Clinic/Center
  • Birmingham, AL
  • NPI 1093768723
  Medicare reassignment NPD
• Northeast Arkansas Clinic Charitable Foundation, Inc.

  • Mobile Mammography Clinic/Center
  • Jonesboro, AR
  • NPI 1417721689

  Multi-Specialty

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Memorial Hospital

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1578527172
  Care Compare affiliation
• Baptist Memorial Hospital- Union City Inc

  • General Acute Care Hospital
  • Union City, TN
  • NPI 1114981768
  Care Compare affiliation
• Baptist Memorial Hospital-Tipton

  • General Acute Care Hospital
  • Covington, TN
  • NPI 1316901937
  Care Compare affiliation
• Baptist Memorial Hospital-Desoto, Inc,

  • General Acute Care Hospital
  • Southaven, MS
  • NPI 1194789818
  Care Compare affiliation
• Baptist Memorial Hospital-Jonesboro Inc

  • General Acute Care Hospital
  • Jonesboro, AR
  • NPI 1386699353
  Care Compare affiliation

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

{
    "created_epoch": "1462233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1538514971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 WOLF RIVER BLVD STE 200",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 WOLF RIVER BLVD STE 200",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381788",
            "telephone_number": "901-747-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTLACK",
        "first_name": "DANIEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-03",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AL",
            "license": "42401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Earnest
• Kelly Earnheart
• East Memphis Allergy and Asthma
• East Memphis Eye Associates PLLC
• Raven Tiara Easter, PHARMD
• Lynn Ebaugh, M.D.
• Paul Richard Eber, M.D.
• Stanley Chinomnso Eboh, MD
• Haylea Layne Echols, DNP, PNP-PC
• Michael L Edelson, M.D.

• Diagnostic Radiology Physician in Germantown, TN
• Providers in Germantown, TN by specialty
• Diagnostic Radiology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.