Meadville Diagnostic Medical Imaging, Inc

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

MEADVILLE DIAGNOSTIC MEDICAL IMAGING, INC

Practice address

751 Liberty St
Meadville, PA 16335-2559

Phone

(814) 333-5603

NPI assigned

Aug 10, 2006

Last updated

Jul 25, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Frederic T McDermott, MDNPI 1558311183

Title

Medical Director

Phone

(814) 333-5603

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Tax ID family

Meadville Diag Med Imaging2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Meadville Diagnostic Medical Imaging Inc

  • Diagnostic Radiology Physician
  • Meadville, PA
  • NPI 1326088691
  NPD tax ID

Locations

Practitioners 5

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.

• Frederic Thomas McDermott, MD

  • Diagnostic Radiology Physician
  • Meadville, PA
  • NPI 1558311183
  Medicare reassignment NPD Authorized official
• Philip Eisinger, DO

  • Diagnostic Radiology Physician
  • Long Beach, CA
  • NPI 1750371852

  PA

  Medicare reassignment NPD
• Hugh S Wilkens, MD

  • Diagnostic Radiology Physician
  • Meadville, PA
  • NPI 1801415567
  NPD (past)
• Bob Greenwald, M.D.

  • Diagnostic Radiology Physician
  • Hackensack, NJ
  • NPI 1144275207
  NPD (past)
• Benjamin Karlberg, M.D.

  • Vascular & Interventional Radiology Physician
  • Cherry Hill, NJ
  • NPI 1205140373
  NPD (past)

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406246400000",
    "number": "1649281379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1198",
            "city": "SOMERSET",
            "state": "PA",
            "postal_code": "155010336",
            "telephone_number": "814-444-8910",
            "fax_number": "814-444-9782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 LIBERTY ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352559",
            "telephone_number": "814-333-5603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEADVILLE DIAGNOSTIC MEDICAL IMAGING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2014-07-25",
        "status": "A",
        "authorized_official_last_name": "MCDERMOTT",
        "authorized_official_first_name": "FREDERIC",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "814-333-5603",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meadville Area Ambulance Service LLC
• Meadville Area Free Clinic
• Meadville Clinical Pathologists, Inc
• Meadville Counseling Center LLC
• Meadville Diagnostic Medical Imaging Inc
• Meadville Emergency Phys PC
• Meadville Medical Associates LLC
• Meadville Medical Center
• Meadville Medical Center (Clinic for Specialty Pain Services)
• Meadville Medical Center

• Specialist in Meadville, PA
• Providers in Meadville, PA by specialty
• Specialist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2014; 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.