NPIMap

Organization Active NPI

Advanced Medical Imaging LLC

  • Diagnostic Radiology Physician
  • Rock Springs, WY
National Provider Identifier
1629169602
Registry record updated Oct 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
ADVANCED MEDICAL IMAGING LLC
Practice address
1200 College Dr
Rock Springs, WY 82901-5868
Phone
(786) 621-3900
Fax
(786) 975-2608
NPI assigned
Sep 27, 2006
Last updated
Oct 5, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2026

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

Authorized official

Name
Frederick Matti, MDNPI 1881652204
Title
Physician
Phone
(786) 621-3900

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 Physician 2085R0202X NU Primary

Addresses

Primary practice location

1200 College Dr
Rock Springs, WY 82901-5868

Mailing address

PO Box 673122
Dallas, TX 75267-3122
Phone (786) 621-3900

Other identifiers 3

IdentifierTypeStateIssuer
612454200OtherDEPT OF LABOR
06012001OtherBCBS OF WY
123400500MedicaidWY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20061226000090 WY Part B Supplier - Clinic/Group Practice 9436159415 Receives reassigned benefits from 6 practitioners
Practice locations: Rock Springs, WY
O20250121000882 MO Part B Supplier - Clinic/Group Practice 9436159415 Receives reassigned benefits from 1 practitioner
Practice locations: Stover, MO

National Provider Directory

National Provider Directory

Locations

1413 Dewar Dr
#32
Rock Springs, WY 82901
Phone (307) 382-0667

706 Elk St
Rock Springs, WY 82901
Phone (307) 362-5352

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791158400000",
    "number": "1629169602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 673122",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752673122",
            "telephone_number": "786-621-3900",
            "fax_number": "786-975-2608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 COLLEGE DR",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829015868",
            "telephone_number": "786-621-3900",
            "fax_number": "786-975-2608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED MEDICAL IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2026-10-05",
        "certification_date": "2026-10-05",
        "status": "A",
        "authorized_official_last_name": "MATTI",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "786-621-3900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "612454200",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF WY",
            "identifier": "06012001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123400500",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Springs, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2026; 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.