NPIMap

Organization Active NPI

Shore Health System Inc

Doing business as Diagnostic and Imaging Center

  • Radiology Clinic/Center
  • Easton, MD
National Provider Identifier
1699286401
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
SHORE HEALTH SYSTEM INC
Doing business as
Diagnostic and Imaging Center
Practice address
10 Martin CT Ste 100
Easton, MD 21601-4095
Phone
(410) 820-7778
Fax
(410) 820-8862
NPI assigned
Oct 19, 2017
Last updated
Nov 27, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
SHORE HEALTH SYSTEM INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Authorized official

Name
Kenneth D Kozel
Title
President & Ceo
Phone
(410) 822-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X NU Primary

Addresses

Primary practice location

10 Martin CT Ste 100
Easton, MD 21601-4095

Mailing address

10 Martin CT Ste 100
Easton, MD 21601-4095
Phone (410) 820-7778

Other names 1

  • Diagnostic and Imaging Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181204000024 MD Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 8022906783 Practice locations: Easton, MD

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Shore Behavioral HLTH20 organizations share this tax ID, including this one
Part of
Shore Behavioral HLTH

Other organizations with this tax ID 19

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

View all 19

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1508371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1699286401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MARTIN CT STE 100",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216014095",
            "telephone_number": "410-820-7778",
            "fax_number": "410-820-8862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MARTIN CT STE 100",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216014095",
            "telephone_number": "410-820-7778",
            "fax_number": "410-820-8862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE HEALTH SYSTEM INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHORE HEALTH SYSTEM INC",
        "enumeration_date": "2017-10-19",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "KOZEL",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "410-822-1000"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diagnostic and Imaging Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Easton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.