NPIMap

Organization Active NPI

Central Wisconsin Radiologists SC

  • Diagnostic Radiology Physician
  • Stevens Point, WI
National Provider Identifier
1629004098
Registry record updated Nov 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
CENTRAL WISCONSIN RADIOLOGISTS SC
Practice address
3410 Stanley St
Stevens Point, WI 54481-1325
Phone
(715) 344-1234
NPI assigned
Jun 25, 2006
Last updated
Nov 10, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2015

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

Authorized official

Name
Michael W Munagian, M.D.NPI 1164695441
Title
President
Phone
(715) 344-1234

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: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

3410 Stanley St
Stevens Point, WI 54481-1325

Mailing address

3410 Stanley St
Stevens Point, WI 54481-1325
Phone (715) 344-1234

Other identifiers 1

IdentifierTypeStateIssuer
32730300MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040416001406 WI Part B Supplier - Clinic/Group Practice 7113912304 Receives reassigned benefits from 10 practitioners
Practice locations: Stevens Point, WI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 19

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 19

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447113600000",
    "number": "1629004098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 STANLEY ST",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544811325",
            "telephone_number": "715-344-1234",
            "fax_number": "715-344-6367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 STANLEY ST",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544811325",
            "telephone_number": "715-344-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL WISCONSIN RADIOLOGISTS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2015-11-10",
        "status": "A",
        "authorized_official_last_name": "MUNAGIAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "715-344-1234",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32730300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stevens Point, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; 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.