NPIMap

Organization Active NPI

North Star MCD, LLC

  • Radiology Clinic/Center
  • Fort Worth, TX
National Provider Identifier
1700550282
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
NORTH STAR MCD, LLC
Practice address
4501 Heritage Trace Pkwy Ste 115
Fort Worth, TX 76244-8941
Phone
(972) 649-6460
NPI assigned
Aug 6, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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

Authorized official

Name
Kevin Saskiw
Title
Co-Ceo
Phone
(972) 649-6460

Specialties & licenses 1

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

Addresses

Primary practice location

4501 Heritage Trace Pkwy Ste 115
Fort Worth, TX 76244-8941

Mailing address

7600 Windrose Ave Ste G325
Plano, TX 75024-0167
Phone (972) 649-6460

Other names 1

  • NORTH STAR DIAGNOSTIC IMAGING Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, HI, OK, GA, CA, CO, NY, MT, FL, WA, PA, NM, KY, SC, VA, MI, NE, WI, AL, IL, AZ21 enrollments

Enrollment records 21

Enrollment IDStateProvider typePAC IDDetails
O20110602000702 TX Part B Supplier - Clinic/Group Practice 2668659434 Receives reassigned benefits from 203 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20180921000026 HI Part B Supplier - Clinic/Group Practice 2668659434 Receives reassigned benefits from 1 practitioner
Practice locations: Honolulu, HI
O20220209002627 OK Part B Supplier - Clinic/Group Practice 2668659434 Receives reassigned benefits from 12 practitioners
1 other NPI on this enrollment
Practice locations: Choctaw, OK; Oklahoma City, OK; Norman, OK; Nichols Hills, OK; Edmond, OK; Duncan, OK
O20220426001558 GA Part B Supplier - Clinic/Group Practice 2668659434 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Canton, GA; Atlanta, GA
O20241010003743 CA Part B Supplier - Clinic/Group Practice 2668659434 Receives reassigned benefits from 10 practitioners
Practice locations: San Francisco, CA; Glendale, CA; San Diego, CA; Rocklin, CA; Poway, CA; Manhattan Beach, CA; Newport Beach, CA; Beverly Hills, CA…
O20241031004125 CO Part B Supplier - Clinic/Group Practice 2668659434 Receives reassigned benefits from 9 practitioners
Practice locations: Avon, CO; Littleton, CO; Fort Collins, CO; Denver, CO; Broomfield, CO; Black Hawk, CO
O20241105000238 NY Part B Supplier - Clinic/Group Practice 2668659434 Receives reassigned benefits from 4 practitioners
Practice locations: Deer Park, NY; Lagrangeville, NY; New York, NY; Valley Stream, NY
O20241105002336 MT Part B Supplier - Clinic/Group Practice 2668659434 Receives reassigned benefits from 1 practitioner
Practice locations: Bozeman, MT
O20241106002545 FL Part B Supplier - Clinic/Group Practice 2668659434 Receives reassigned benefits from 8 practitioners
Practice locations: Weston, FL; Port St Lucie, FL; Palm Beach Gardens, FL; Orlando, FL; Miami, FL; Boynton Beach, FL; Lake Mary, FL; Fort Myers, FL
O20241106002560 WA Part B Supplier - Clinic/Group Practice 2668659434 Receives reassigned benefits from 2 practitioners
Practice locations: White Salmon, WA; Woodinville, WA
O20241112001669 PA Part B Supplier - Clinic/Group Practice 2668659434 Receives reassigned benefits from 4 practitioners
Practice locations: Presto, PA; Swarthmore, PA; Orwigsburg, PA; Ambler, PA
O20241119000568 NM Part B Supplier - Clinic/Group Practice 2668659434 Receives reassigned benefits from 1 practitioner
Practice locations: Las Cruces, NM
O20241127001372 KY Part B Supplier - Clinic/Group Practice 2668659434 Receives reassigned benefits from 1 practitioner
Practice locations: Nicholasville, KY
O20241202001645 SC Part B Supplier - Clinic/Group Practice 2668659434 Receives reassigned benefits from 9 practitioners
Practice locations: Simpsonville, SC; Greenville, SC; Blythewood, SC
O20241203000067 VA Part B Supplier - Clinic/Group Practice 2668659434 Receives reassigned benefits from 3 practitioners
Practice locations: Norfolk, VA; Virginia Beach, VA
O20241211000340 MI Part B Supplier - Clinic/Group Practice 2668659434 Receives reassigned benefits from 2 practitioners
Practice locations: Fruitport, MI
O20250226003093 NE Part B Supplier - Clinic/Group Practice 2668659434 Receives reassigned benefits from 1 practitioner
Practice locations: Columbus, NE
O20250313000683 WI Part B Supplier - Clinic/Group Practice 2668659434 Receives reassigned benefits from 1 practitioner
Practice locations: Menomonee Falls, WI
O20250523000303 AL Part B Supplier - Clinic/Group Practice 2668659434 Receives reassigned benefits from 1 practitioner
Practice locations: Daphne, AL
O20251231001067 IL Part B Supplier - Clinic/Group Practice 2668659434 Receives reassigned benefits from 1 practitioner
Practice locations: Girard, IL
O20260603003332 AZ Part B Supplier - Clinic/Group Practice 2668659434 Receives reassigned benefits from 2 practitioners
Practice locations: Gilbert, AZ; Peoria, AZ

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 10

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

National Provider Directory

National Provider Directory
Tax ID family
North Star Diagnostic Imaging10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

112 Herff Rd
Ste 120
Boerne, TX 78006
Phone (210) 961-4282

11970 N Central Expy
Ste 100
Dallas, TX 75243
Phone (469) 248-1000

209 N Bonnie Brae St
Bldg 3
Denton, TX 76201
Phone (972) 539-0086

2535 Ira E Woods Ave
Ste 101
Grapevine, TX 76051

4803 Wesley St
Greenville, TX 75401
Phone (903) 454-2246

230 S Preston Rd
Ste 10
Prosper, TX 75078
Phone (469) 715-4878

Practitioners & affiliated clinicians

Practitioners 253

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

View all 253

NPI Registry JSON

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

{
    "created_epoch": "1628208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628208000000",
    "number": "1700550282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 WINDROSE AVE STE G325",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750240167",
            "telephone_number": "972-649-6460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 HERITAGE TRACE PKWY STE 115",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762448941",
            "telephone_number": "972-649-6460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH STAR MCD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-06",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A",
        "authorized_official_last_name": "SASKIW",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CO-CEO",
        "authorized_official_telephone_number": "972-649-6460"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NORTH STAR DIAGNOSTIC IMAGING",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; 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.