Beaches MRI of PSL, LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

EXEMPT Issued in FL

Legal business name

BEACHES MRI OF PSL, LLC

Doing business as

Beaches MRI of PSL

Practice address

10377 S US Highway 1
Ste 100
Port St Lucie, FL 34952-5630

Phone

(772) 337-9191

Fax

(772) 337-7772

NPI assigned

Oct 30, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Andrew T Walker, M.D.

Title

Officer

Phone

(772) 323-7321

Specialties & licenses 2

Addresses

Other names 1

• Beaches MRI of PSL Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark S. Frisk, M.D.

  • Specialist
  • Jacksonville Beach, FL
  • NPI 1831222165
  Medicare reassignment NPD
• Henry R. Zayas, M.D.

  • Specialist
  • Stuart, FL
  • NPI 1932326345
  Medicare reassignment NPD

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

{
    "created_epoch": "1383091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383091200000",
    "number": "1639507585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 NW FEDERAL HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349949629",
            "telephone_number": "772-337-9191",
            "fax_number": "772-337-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10377 S US HIGHWAY 1",
            "address_2": "STE 100",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525630",
            "telephone_number": "772-337-9191",
            "fax_number": "772-337-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACHES MRI OF PSL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-30",
        "last_updated": "2013-10-30",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "772-323-7321",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Neuroradiology",
            "state": "FL",
            "license": "EXEMPT",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "EXEMPT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beaches MRI of PSL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Diagnostic Radiology Physician in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Diagnostic Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2013; 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.