NPIMap

Organization Active NPI

All-Stat Portable MD LLC

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Beltsville, MD
National Provider Identifier
1548869894
Registry record updated Oct 30, 2024
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
ALL-STAT PORTABLE MD LLC
Practice address
5010 Sunnyside Ave
Ste 305
Beltsville, MD 20705-2320
Phone
(301) 680-1900
Fax
(301) 680-0920
NPI assigned
Oct 19, 2020
Last updated
Oct 30, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ALL-STAT PORTABLE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Authorized official

Name
Mr. Etai Sooliman
Title
Ceo
Phone
(224) 337-1199

Specialties & licenses 1

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

Addresses

Primary practice location

5010 Sunnyside Ave
Ste 305
Beltsville, MD 20705-2320

Mailing address

8235 Christiana Ave
Skokie, IL 60076-2910
Phone (224) 337-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210312000191 MD Part B Supplier - Portable X-Ray Supplier 7517379472 Practice locations: Beltsville, MD
O20210312000232 DC Part B Supplier - Portable X-Ray Supplier 7517379472 Practice locations: Beltsville, MD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1548869894. Details of each certification follow.

Portable X-ray supplier certification: CCN 21X0009809

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
ALL-STAT PORTABLE MD LLC
Certification status
Active
Provider type (POS)
Portable X-ray supplier
Participating since
Sep 18, 1991
Last certification
Aug 2, 2022
Ownership / control type
Partnership
Most recent change of ownership
Nov 9, 2020
Facility address
5010 Sunnyside Ave Ste 305
Beltsville, MD 20705

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
All-Stat Portable MD 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.

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730246400000",
    "number": "1548869894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8235 CHRISTIANA AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762910",
            "telephone_number": "224-337-1000",
            "fax_number": "224-337-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 SUNNYSIDE AVE",
            "address_2": "STE 305",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207052320",
            "telephone_number": "301-680-1900",
            "fax_number": "301-680-0920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALL-STAT PORTABLE MD LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALL-STAT PORTABLE LLC",
        "enumeration_date": "2020-10-19",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "SOOLIMAN",
        "authorized_official_first_name": "ETAI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "224-337-1199",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beltsville, MD

Sources for this page

Verify at the official NPI Registry.