Individual provider Active NPI

Nathan Bumbarger, M.D.

  • Body Imaging Physician
  • Jbsa Lackland, TX
National Provider Identifier
1568845667
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Body Imaging PhysicianTaxonomy code 2085B0100X
License
D0095945 Issued in MD
Practice address
1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638
Phone
(210) 292-7934
Fax
(210) 292-7934
NPI assigned
Jul 7, 2015
Last updated
Sep 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X D0095945 MD Primary
Diagnostic Radiology Physician 2085R0202X 0116027992 VA

Addresses

Primary practice location

1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638

Mailing address

1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230623003134 DC Practitioner - Diagnostic Radiology 1951769884 Reassigns benefits to 1 organization
I20250501000353 VA Practitioner - Diagnostic Radiology 1951769884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0095945MDMDBody Imaging Physician
0116027992VAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Whasc CurrentSince Dec 29, 2024 Accepting new patients
Insight Health Corp Diagnostic Radiology CurrentSince Apr 1, 2025 Accepting new patients
Insight Health Corp. Diagnostic Radiology CurrentSince Apr 1, 2025 Accepting new patients
University of Maryland Diagnostic Radiology, LLC Diagnostic Radiology CurrentSince Jul 1, 2023 Accepting new patients
University of Maryland Diagnostic Radiology, LLC Diagnostic Radiology CurrentSince Jul 1, 2023 Accepting new patients
University of Maryland Diagnostic Imaging Specialists P a Diagnostic Radiology PastSince Jan 26, 2025 Accepting new patients
Columbus Radiology Corp Diagnostic Radiology Past Accepting new patients

Locations

22 S Greene St
Rm N2E23
Baltimore, MD 21201
Phone (410) 328-5656

5 N La Plata Ct
Ste 104
La Plata, MD 20646
Phone (301) 539-0345

5775 Wayzata Blvd
Ste 400
St Louis Park, MN 55416
Phone (952) 525-6338

1100 Wilford Hall Loop
Bldg 4554
San Antonio, TX 78236
Phone (210) 292-6225

4001 Prince William Pkwy
Ste 104
Woodbridge, VA 22192
Phone (703) 490-3677

Organizations & group practices 8

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": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1568845667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP BLDG 4554",
            "city": "JBSA LACKLAND",
            "state": "TX",
            "postal_code": "782365638",
            "telephone_number": "210-292-7934",
            "fax_number": "210-292-7934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUMBARGER",
        "first_name": "NATHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-07",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "MD",
            "license": "D0095945",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0116027992",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbsa Lackland, TX

Sources for this page

Verify at the official NPI Registry.