Individual provider Active NPI

Collin Randall Edwards, MD

  • Diagnostic Radiology Physician
  • Greenwich, CT
National Provider Identifier
1558998807
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD490565 Issued in PA
Practice address
5 Perryridge Rd
Greenwich, CT 06830-4608
Phone
(203) 863-3409
NPI assigned
Mar 26, 2020
Last updated
Sep 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD490565 PA Primary

Addresses

Primary practice location

5 Perryridge Rd
Greenwich, CT 06830-4608

Mailing address

6848 Chorleywood Cir
Indianapolis, IN 46259-5501

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250915004344 PA Practitioner - Diagnostic Radiology 1557879848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
New York Medical College, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1101 Market St
Philadelphia, PA 19107-2955

5001 Lyndon B Johnson Fwy
Suite 320
Dallas, TX 75244

5650 Paul Blazer Pkwy
Suite 104
Dublin, OH 43017-3562

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD490565PAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Associates in Healthcare, Inc. CurrentSince Sep 1, 2025 Accepting new patients
Methodist Associates in Healthcare, Inc Diagnostic Radiology Current Accepting new patients
Methodist Associates in Healthcare, Inc CurrentSince Sep 1, 2025 Accepting new patients

Locations

1101 Market St
Fl 19
Philadelphia, PA 19107
Phone (215) 481-6836

2301 S Broad St
Ste 102
Philadelphia, PA 19148
Phone (215) 952-5175

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1558998807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6848 CHORLEYWOOD CIR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462595501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 PERRYRIDGE RD",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068304608",
            "telephone_number": "203-863-3409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "COLLIN",
        "middle_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD490565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwich, CT

Sources for this page

Verify at the official NPI Registry.