Concord Imaging Center
Organization Active NPI Radiology Clinic/Center · Concord, NH
NPI 1700859451 · NPPES record last updated Jul 31, 2020
Key facts
- NPI
- 1700859451
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Radiology Clinic/Center 261QR0200X
- Legal business name
- CONCORD IMAGING CENTER
- Practice address
- 2 1/2 Beacon St
Concord, NH 03301-4447 - Phone
- (603) 228-1521
- Fax
- (603) 225-2510
- NPI assigned
- Feb 10, 2006
- Organization subpart
- No
Authorized official
- Name
- Timothy J McCormack, MD
- Title
- Director
- Phone
- (603) 228-1521
Practitioners 25
-
Herlen Alencar, M.D.
-
Matthew H Dimasi, MD
-
David Andrew Glazier, M.D.
-
Steffen Haider, MD
-
Arie I Salis, M.D.
-
Jesse B Smith, MD
-
Joseph G Venus, M.D.
-
William Collins Wrobel, M.D.
-
Daniel Tyler Zapton, M.D.
-
Gregory Aaron Bonci, M.D.
-
Amin Chaoui, MD
-
Bryan Thomas Suchecki, M.D.
-
Anji Tang, MD
-
Steven V Manzi, MD
-
Dan Nir, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040421000655 | NH | Part B Supplier - Clinic/Group Practice | 2466448030 |
Receives reassigned benefits from 23 practitioners Practice locations: Concord, NH |
National Provider Directory
Locations
248 Pleasant St
Ste 102
Concord, NH 03301
248 Pleasant St
Ste 106
Concord, NH 03301
60 Commercial St
Ste 101
Concord, NH 03301
1990 Dover Rd
Epsom, NH 03234
Phone (603) 736-3047
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | |||
| Magnetic Resonance Imaging (MRI) Clinic/Center | 261QM1200X | |||
| Radiology Clinic/Center | 261QR0200X | Yes | ||
| Mammography Clinic/Center | 261QR0206X |
Addresses
Primary practice location
2 1/2 Beacon St
Concord, NH 03301-4447
Mailing address
2 1/2 Beacon St
Concord, NH 03301-4447
Phone (603) 228-1521
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CONC300975 | Other | NH | ANTHEM BCBS OF NH |
| 30814375 | Medicaid | NH | |
| CB4403 | Other | NH | RAILROAD MEDICARE |
Other providers in Concord, NH
- Concord Hospital, Inc.
- Concord Hospital, Inc.
- Concord Hospital, Inc.
- Concord Hospital, Inc.
- Concord Hospital, Inc.
- Concord Neurological Associates
- Concord Ophthalmologic Associates PA
- Concord Ophthalmologic Associates PA
- Concord Oral Surgery Professional Association
- Concord Orthodontics, PLLC
All providers in Concord, NH · Radiology Clinic/Center in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2020. 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.