NPIMap

Organization Active NPI

Stockdale Radiology Physicians Services, Inc

  • Diagnostic Radiology Physician
  • Bakersfield, CA
National Provider Identifier
1669806402
Registry record updated Sep 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
20A9263 Issued in CA
Legal business name
STOCKDALE RADIOLOGY PHYSICIANS SERVICES, INC
Practice address
4000 Empire Dr
Suite 100
Bakersfield, CA 93309-0441
Phone
(661) 631-8000
Fax
(661) 631-8005
NPI assigned
Aug 28, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2016

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

Authorized official

Name
David G Suadi, D.O.NPI 1114911799
Title
President
Phone
(661) 631-8000

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: 193200000X MULTI-SPECIALTY GROUP 2085R0202X 20A9263 CA Primary

Addresses

Primary practice location

4000 Empire Dr
Suite 100
Bakersfield, CA 93309-0441

Mailing address

4000 Empire Dr
Suite 100
Bakersfield, CA 93309-0441
Phone (661) 631-8000

Other names 1

  • Stockdale Radiology Physicians Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NY, FL4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20140305000661 CA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 6002046422 Practice locations: Bakersfield, CA
O20140429000939 CA Part B Supplier - Clinic/Group Practice 6002046422 Receives reassigned benefits from 7 practitioners
3 other NPIs on this enrollment
Practice locations: Taft, CA; Shafter, CA; Palm Desert, CA; Bakersfield, CA; Lamont, CA
O20170627001432 NY Part B Supplier - Clinic/Group Practice 6002046422 Receives reassigned benefits from 1 practitioner
Practice locations: Merrick, NY
O20210518000142 FL Part B Supplier - Clinic/Group Practice 6002046422 Receives reassigned benefits from 2 practitioners
Practice locations: North Port, FL; Clearwater, FL

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

901 Olive Dr
Ste 104
Bakersfield, CA 93308

2700 F St
Ste 100
Bakersfield, CA 93301
Phone (661) 325-5513

8933 Panama Rd
Ste 104
Lamont, CA 93241

8933 Panama Rd
Lamont, CA 93241

333 S 10th St
Ste 104
Taft, CA 93268

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1377648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474416000000",
    "number": "1669806402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 EMPIRE DR",
            "address_2": "SUITE 100",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933090441",
            "telephone_number": "661-631-8000",
            "fax_number": "661-631-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 EMPIRE DR",
            "address_2": "SUITE 100",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933090441",
            "telephone_number": "661-631-8000",
            "fax_number": "661-631-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STOCKDALE RADIOLOGY PHYSICIANS SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-28",
        "last_updated": "2016-09-21",
        "status": "A",
        "authorized_official_last_name": "SUADI",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "661-631-8000",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "20A9263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stockdale Radiology Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; 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.