Advanced Imaging Specialists, LLC
Organization Active NPI Diagnostic Radiology Physician · Hartford, CT
NPI 1689429078 · NPPES record last updated May 6, 2025
Key facts
- NPI
- 1689429078
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- Legal business name
- ADVANCED IMAGING SPECIALISTS, LLC
- Practice address
- 114 Woodland St
Hartford, CT 06105-1208 - Phone
- (203) 426-3002
- NPI assigned
- Apr 19, 2024
- Organization subpart
- No
Authorized official
- Name
- Kirt Frederickson, MD
- Title
- President
- Phone
- (203) 426-3002
Member of 1
Practitioners 63
-
Malavika Bhalla, MD
-
Philip A Dinauer, MD
-
John F Flynn Jr., M.D.
-
Robert B Hansen, M.D.
-
Jeffrey Hawley, MD
-
Diana James, M.D., PH.D.
-
Athena H Lantz, MD
-
Jennifer C. Logan, M.D.
-
Paul V McGuire, MD
-
Pongsa-Pyn Muangman, M.D.
-
Sarah H O'Connell, M.D.
-
Nirav A Patel, MD
-
Madhavi Raghu, MD
-
Bhawana Rathore, MD
-
Charan Singh, MD
-
Adam Welber, M.D.
-
Fardad Behzadi, MD
-
Michael Chill, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240808003398 | CT | Part B Supplier - Clinic/Group Practice | 9234676164 |
Receives reassigned benefits from 60 practitioners Practice locations: Hartford, CT; Waterbury, CT; Stafford Springs, CT; Enfield, CT |
National Provider Directory
Locations
35 Nod Rd
Avon, CT 06001
Phone (860) 409-1559
1000 Asylum Ave
Hartford, CT 06105
Phone (860) 714-4532
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | Yes |
Addresses
Primary practice location
114 Woodland St
Hartford, CT 06105-1208
Mailing address
2 Riverview Dr Ste 104
Danbury, CT 06810-6268
Phone (203) 426-3002
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.