NPIMap

Diagnostic Radiology Associates, LLC

Organization Active NPI Radiology Clinic/Center · Waterbury, CT

NPI 1700837374 · NPPES record last updated Nov 7, 2023

Key facts

NPI
1700837374
Entity type
Organization (NPI type 2)
Primary specialty
Radiology Clinic/Center 261QR0200X
Legal business name
DIAGNOSTIC RADIOLOGY ASSOCIATES, LLC
Practice address
134 Grandview Ave
Waterbury, CT 06708-2507
Phone
(203) 756-8911
Fax
(203) 574-0548
NPI assigned
May 16, 2006
Organization subpart
No

Authorized official

Name
Duncan Belcher, MD NPI 1245295054
Title
Managing Partner
Phone
(203) 756-8911

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Practitioners 46

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

View all 46

Medicare participation

Medicare fee-for-service enrollment
Enrolled (16 enrollments) in CT, IL, NC, CA, NY, FL, OH, TX, WA, MT, UT, VA, PA, MA, MO, SC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20060629000386 CT Part B Supplier - Clinic/Group Practice 7113939505 Receives reassigned benefits from 12 practitioners
Practice locations: Middlebury, CT; Waterbury, CT
O20220930001516 IL Part B Supplier - Clinic/Group Practice 7113939505 Receives reassigned benefits from 2 practitioners
Practice locations: Chicago, IL; Lake Forest, IL; South Barrington, IL
O20221012001252 NC Part B Supplier - Clinic/Group Practice 7113939505 Receives reassigned benefits from 2 practitioners
Practice locations: Sanford, NC; Winston Salem, NC
O20221107003172 CA Part B Supplier - Clinic/Group Practice 7113939505 Receives reassigned benefits from 4 practitioners
Practice locations: Exeter, CA; Stockton, CA; Santa Monica, CA; Oceanside, CA; Claremont, CA; Carlsbad, CA
O20221109000191 NY Part B Supplier - Clinic/Group Practice 7113939505 Receives reassigned benefits from 1 practitioner
Practice locations: Howard Beach, NY; New York, NY; Saint James, NY
O20221117002990 FL Part B Supplier - Clinic/Group Practice 7113939505 Receives reassigned benefits from 3 practitioners
Practice locations: Port Saint Lucie, FL; Orlando, FL; Boca Raton, FL
O20221117003079 OH Part B Supplier - Clinic/Group Practice 7113939505 Receives reassigned benefits from 1 practitioner
Practice locations: Beavercreek, OH
O20221130000413 TX Part B Supplier - Clinic/Group Practice 7113939505 Receives reassigned benefits from 7 practitioners
Practice locations: Spring, TX; San Antonio, TX; Lakehills, TX; Fort Worth, TX; Midland, TX
O20221222001662 WA Part B Supplier - Clinic/Group Practice 7113939505 Receives reassigned benefits from 1 practitioner
Practice locations: Bremerton, WA
O20231122001251 MT Part B Supplier - Clinic/Group Practice 7113939505 Practice locations: Butte, MT
O20240924002147 UT Part B Supplier - Clinic/Group Practice 7113939505 Receives reassigned benefits from 1 practitioner
Practice locations: Bountiful, UT
O20250103000067 VA Part B Supplier - Clinic/Group Practice 7113939505 Receives reassigned benefits from 1 practitioner
Practice locations: Chesapeake, VA
O20250106003207 PA Part B Supplier - Clinic/Group Practice 7113939505 Receives reassigned benefits from 1 practitioner
Practice locations: Clarks Summit, PA
O20251001000359 MA Part B Supplier - Clinic/Group Practice 7113939505 Receives reassigned benefits from 2 practitioners
Practice locations: Boston, MA; Orleans, MA
O20260116002624 MO Part B Supplier - Clinic/Group Practice 7113939505 Receives reassigned benefits from 1 practitioner
Practice locations: Columbia, MO
O20260122002671 SC Part B Supplier - Clinic/Group Practice 7113939505 Receives reassigned benefits from 1 practitioner
Practice locations: Mount Pleasant, SC

National Provider Directory

Locations

134 Grandview Ave
Ste 101
Waterbury, CT 06708
Phone 2035969793254

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 2085R0202X
Radiology Clinic/Center 261QR0200X Yes

Addresses

Primary practice location

134 Grandview Ave
Waterbury, CT 06708-2507

Mailing address

134 Grandview Ave
Waterbury, CT 06708-2507
Phone (203) 756-8911

Other identifiers

IdentifierTypeStateIssuer
004000808MedicaidCT

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 7, 2023.

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699315200000",
    "number": "1700837374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 GRANDVIEW AVE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082507",
            "telephone_number": "203-756-8911",
            "fax_number": "203-574-0548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 GRANDVIEW AVE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082507",
            "telephone_number": "203-756-8911",
            "fax_number": "203-574-0548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC RADIOLOGY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A",
        "authorized_official_last_name": "BELCHER",
        "authorized_official_first_name": "DUNCAN",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "203-756-8911",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004000808",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

All providers in Waterbury, CT · Radiology Clinic/Center in Connecticut

Sources for this page

Verify at the official NPI Registry.