Active NPI
Prescott Radiologists LLP
- Specialist
- Prescott, AZ
National Provider Identifier
1689636243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Legal business name
- PRESCOTT RADIOLOGISTS LLP
- Practice address
- 1003 Willow Creek Rd
Prescott, AZ 86301-1641 - Phone
- (928) 778-1971
- Fax
- (982) 771-5733
- NPI assigned
- Apr 6, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Michael J Dangelo, MD
- Title
- Medical Director
- Phone
- (928) 778-1971
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Primary |
Addresses
Primary practice location
1003 Willow Creek Rd
Prescott, AZ 86301-1641
Mailing address
PO Box 678308
Dallas, KS 75267-8308
Phone (928) 445-2700
Other names 1
- Prescott Imaging Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ, TX, SC
Enrollment records 3
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040623001105 | AZ | Part B Supplier - Clinic/Group Practice | 4082699947 |
Receives reassigned benefits from 10 practitioners Practice locations: Prescott, AZ; Prescott Valley, AZ; Scottsdale, AZ; Chandler, AZ; Mesa, AZ; Gilbert, AZ; Glendale, AZ |
| O20250714003611 | TX | Part B Supplier - Clinic/Group Practice | 4082699947 |
Receives reassigned benefits from 2 practitioners Practice locations: Addison, TX; Lubbock, TX |
| O20251002000274 | SC | Part B Supplier - Clinic/Group Practice | 4082699947 |
Receives reassigned benefits from 1 practitioner Practice locations: Folly Beach, SC |
National Provider Directory
National Provider DirectoryLocations
1000 Ainsworth Dr
Ste 215
Prescott, AZ 86305
1000 Ainsworth Dr
Ste 115
Prescott, AZ 86305
Phone (928) 778-1971
Practitioners & affiliated clinicians
Practitioners 17
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": "1144281600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1499731200000",
"number": "1689636243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 678308",
"city": "DALLAS",
"state": "KS",
"postal_code": "752678308",
"telephone_number": "928-445-2700",
"fax_number": "800-656-0593"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1003 WILLOW CREEK RD",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863011641",
"telephone_number": "928-778-1971",
"fax_number": "982-771-5733"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PRESCOTT RADIOLOGISTS LLP",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-06",
"last_updated": "2017-07-11",
"status": "A",
"authorized_official_last_name": "DANGELO",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "928-778-1971",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Prescott Imaging Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Prescott, AZ
- Prescott Osteoporosis Testing Center
- Prescott Outpatient Surgical Center LLC
- Prescott Periodontics & Implant Dentistry, PLLC
- Prescott Pulmonary and Sleep Specialists, PLLC
- Prescott Radiation Oncology Specialists LLC
- Prescott Recovery Services LLC
- Prescott Relationship Center, PLLC
- Prescott Sleep Solutions Inc
- Prescott Smile Care
- Prescott Speech & Language Services Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2017; 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.