NPIMap

Organization Active NPI

Specialists in Diagnostic Imaging PA

  • Diagnostic Radiology Physician
  • Deerfield Beach, FL
National Provider Identifier
1558347724
Registry record updated Feb 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
65003 Issued in FL
Legal business name
SPECIALISTS IN DIAGNOSTIC IMAGING PA
Practice address
629A E Hillsboro Blvd
Deerfield Beach, FL 33441-3517
Phone
(954) 698-9399
Fax
(954) 698-6963
NPI assigned
Dec 20, 2005
Last updated
Feb 19, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2018

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

Authorized official

Name
Mrs. Karen Jodat
Title
Director of Operations
Phone
(954) 698-9399

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME65690 FL
Diagnostic Radiology Physician 2085R0202X ME55202 FL
Diagnostic Radiology Physician 2085R0202X ME89839 FL
Diagnostic Radiology Physician 2085R0202X 98490 FL
Diagnostic Radiology Physician 2085R0202X ME91665 FL
Diagnostic Radiology Physician 2085R0202X 103039 FL
Diagnostic Radiology Physician 2085R0202X 102211 FL
Diagnostic Radiology Physician 2085R0202X 91257 FL
Diagnostic Radiology Physician 2085R0202X 60421 FL
Diagnostic Radiology Physician 2085R0202X 98042 FL
Diagnostic Radiology Physician 2085R0202X 86013 FL
Diagnostic Radiology Physician 2085R0202X ME60421 VA
Diagnostic Radiology Physician 2085R0202X ME89839 NC
Diagnostic Radiology Physician 2085R0202X ME 94156 FL
Diagnostic Radiology Physician 2085R0202X 65003 FL Primary

Addresses

Primary practice location

629A E Hillsboro Blvd
Deerfield Beach, FL 33441-3517

Mailing address

629A E Hillsboro Blvd
Suite a
Deerfield Beach, FL 33441-3517
Phone (954) 698-9399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, VA, PA, TX, CA, NJ, IN, NY, ME9 enrollments

Enrollment records 9

Enrollment IDStateProvider typePAC IDDetails
O20040122000021 FL Part B Supplier - Clinic/Group Practice 0244132124 Receives reassigned benefits from 15 practitioners
Practice locations: Boca Raton, FL; Deerfield Beach, FL; Highland Beach, FL; Lake Mary, FL; Ocala, FL; Weston, FL
O20090113000714 VA Part B Supplier - Clinic/Group Practice 0244132124 Receives reassigned benefits from 3 practitioners
Practice locations: Forest, VA; Keswick, VA; Richmond, VA
O20090202000381 PA Part B Supplier - Clinic/Group Practice 0244132124 Receives reassigned benefits from 2 practitioners
Practice locations: Pittsburgh, PA; Philadelphia, PA
O20090205000163 TX Part B Supplier - Clinic/Group Practice 0244132124 Receives reassigned benefits from 3 practitioners
Practice locations: Austin, TX; College Station, TX; Fair Oaks Ranch, TX
O20090915000812 CA Part B Supplier - Clinic/Group Practice 0244132124 Receives reassigned benefits from 1 practitioner
Practice locations: Los Altos, CA
O20120404000080 NJ Part B Supplier - Clinic/Group Practice 0244132124 Receives reassigned benefits from 2 practitioners
Practice locations: Moorestown, NJ; Delran, NJ
O20120605000163 IN Part B Supplier - Clinic/Group Practice 0244132124 Receives reassigned benefits from 1 practitioner
Practice locations: Zionsville, IN
O20120712000245 NY Part B Supplier - Clinic/Group Practice 0244132124 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY
O20211028001175 ME Part B Supplier - Clinic/Group Practice 0244132124 Receives reassigned benefits from 1 practitioner
Practice locations: Bath, ME

National Provider Directory

National Provider Directory

Locations

629A E Hillsboro Blvd
Ste A
Deerfield Beach, FL 33441

13798 NW 4th St
Ste 305
Sunrise, FL 33325
Phone (954) 846-1117

500 University Dr
#H66
Hershey, PA 17033
Phone (717) 531-8044

Practitioners & affiliated clinicians

Practitioners 29

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 29

NPI Registry JSON

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518998400000",
    "number": "1558347724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629A E HILLSBORO BLVD",
            "address_2": "SUITE A",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334413517",
            "telephone_number": "954-698-9399",
            "fax_number": "954-698-6963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629A E HILLSBORO BLVD",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334413517",
            "telephone_number": "954-698-9399",
            "fax_number": "954-698-6963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALISTS IN DIAGNOSTIC IMAGING PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-20",
        "last_updated": "2018-02-19",
        "status": "A",
        "authorized_official_last_name": "JODAT",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "954-698-9399",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME65690",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME55202",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME89839",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "98490",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME91665",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "103039",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "102211",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "91257",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "60421",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "98042",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "86013",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "ME60421",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "ME89839",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME 94156",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "65003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2018; 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.