NPIMap

Organization Active NPI

Pet-CT Imaging of Berkeley, LLC

  • Diagnostic Radiology Physician
  • Berkeley, CA
National Provider Identifier
1639217904
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
PET-CT IMAGING OF BERKELEY, LLC
Practice address
2855 Telegraph Ave Ste 100
Berkeley, CA 94705-1149
Phone
(510) 204-9400
Fax
(510) 204-0600
NPI assigned
Feb 1, 2007
Last updated
Feb 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Authorized official

Name
Mr. Curtis Himy
Title
Owner
Phone
(510) 204-9400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X Primary

Addresses

Primary practice location

2855 Telegraph Ave Ste 100
Berkeley, CA 94705-1149

Mailing address

2855 Telegraph Ave Ste 100
Berkeley, CA 94705-1149
Phone (510) 204-9400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040819001021 CA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 0042284739 Practice locations: Berkeley, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707350400000",
    "number": "1639217904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2855 TELEGRAPH AVE STE 100",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947051149",
            "telephone_number": "510-204-9400",
            "fax_number": "510-204-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 TELEGRAPH AVE STE 100",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947051149",
            "telephone_number": "510-204-9400",
            "fax_number": "510-204-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PET-CT IMAGING OF BERKELEY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A",
        "authorized_official_last_name": "HIMY",
        "authorized_official_first_name": "CURTIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-204-9400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; 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.