NPIMap

Organization Active NPI

Precision Diagnostic Radiology LLC

  • Diagnostic Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1558053181
Registry record updated May 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
PRECISION DIAGNOSTIC RADIOLOGY LLC
Practice address
5800 Ridge Ave
Philadelphia, PA 19128
Phone
(215) 483-9900
NPI assigned
May 23, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2023

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

Authorized official

Name
Dr. David Nussbaum, MDNPI 1144379041
Title
President
Phone
(410) 398-4000

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

5800 Ridge Ave
Philadelphia, PA 19128

Mailing address

112 Chesley Dr
Media, PA 19063-1762
Phone (888) 333-8131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, IL, NY, DE, MD, DC, CA, CO8 enrollments

Enrollment records 8

Enrollment IDStateProvider typePAC IDDetails
O20230726000637 PA Part B Supplier - Clinic/Group Practice 3375904253 Receives reassigned benefits from 7 practitioners
Practice locations: Landenberg, PA; Wynnewood, PA; Philadelphia, PA; Garnet Valley, PA; Chadds Ford, PA
O20230821002780 IL Part B Supplier - Clinic/Group Practice 3375904253 Receives reassigned benefits from 1 practitioner
Practice locations: Highland Park, IL
O20231023001784 NY Part B Supplier - Clinic/Group Practice 3375904253 Practice locations: New York, NY
O20231026002705 DE Part B Supplier - Clinic/Group Practice 3375904253 Receives reassigned benefits from 1 practitioner
Practice locations: New Castle, DE
O20231027001106 MD Part B Supplier - Clinic/Group Practice 3375904253 Receives reassigned benefits from 7 practitioners
Practice locations: Elkton, MD; Perryville, MD
O20231109003457 DC Part B Supplier - Clinic/Group Practice 3375904253 Receives reassigned benefits from 1 practitioner
Practice locations: Silver Spring, MD
O20240320003433 CA Part B Supplier - Clinic/Group Practice 3375904253 Receives reassigned benefits from 1 practitioner
Practice locations: Alameda, CA
O20250623004062 CO Part B Supplier - Clinic/Group Practice 3375904253 Receives reassigned benefits from 1 practitioner
Practice locations: Erie, CO

National Provider Directory

National Provider Directory

Locations

112 Chesley Dr
Media, PA 19063

Practitioners & affiliated clinicians

Practitioners 40

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1684800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684800000000",
    "number": "1558053181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 CHESLEY DR",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190631762",
            "telephone_number": "888-333-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 RIDGE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19128",
            "telephone_number": "215-483-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRECISION DIAGNOSTIC RADIOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-23",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-12",
        "status": "A",
        "authorized_official_last_name": "NUSSBAUM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-398-4000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; 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.