NPIMap

Organization Active NPI

All-Stat Portable MD LLC

  • Mobile Radiology Clinic/Center
  • Beltsville, MD
National Provider Identifier
1568061869
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X
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
May 29, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
ALL-STAT PORTABLE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 29, 2025

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mobile Radiology Clinic/Center 261QR0208X Primary
Physiological Laboratory 293D00000X

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

Other practice location 1

3701 Old Court Rd Ste 7B
Baltimore, MD 21208-3901
Phone (301) 680-1900

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20201217000763 MD Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 7517379472 Practice locations: Baltimore, MD
O20201222002011 DC Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 7517379472 Practice locations: Beltsville, MD

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 27

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 27

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": "1748476800000",
    "number": "1568061869",
    "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": [
        {
            "address_1": "3701 Old Court Rd Ste 7B",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212083901",
            "country_code": "US",
            "telephone_number": "301-680-1900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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": "2025-05-29",
        "certification_date": "2025-05-29",
        "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": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beltsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; 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.