Individual provider Active NPI

Elliot H Himmelfarb, M.D.

  • Diagnostic Radiology Physician
  • Goodlettsville, TN
National Provider Identifier
1710932017
Registry record updated Nov 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD8191 Issued in TN
Practice address
3024 Business Park Cir
Goodlettsville, TN 37072-3132
Phone
(615) 851-6033
Fax
(615) 851-2018
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD8191 TN Primary

Addresses

Primary practice location

3024 Business Park Cir
Goodlettsville, TN 37072-3132

Mailing address

3024 Business Park Cir
Goodlettsville, TN 37072-3132
Phone (615) 851-6033

Other identifiers 9

IdentifierTypeStateIssuer
1509269OtherTNMEDICAID - MTI
4068857OtherTNBCBS
4200724OtherTNBCBS TN
64071590OtherKYKY MEDICAID
1509269MedicaidTN
4068499OtherTNBCBS
PENDINGOtherTNRAILROAD MEDICARE
4291392OtherTNBCBS - MTI
3161070MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20031217000569 TN Practitioner - Interventional Radiology 2961309919 Reassigns benefits to 2 organizations
I20190703002009 WI Practitioner - Diagnostic Radiology 2961309919 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD8191TNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia St. Mary'S Hospital Milwaukee, Inc CurrentSince May 28, 2019 Accepting new patients
Advanced Diagnostic Imaging PC CurrentSince Oct 1, 2003 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince May 28, 2019 Accepting new patients
Advanced Diagnostic Imaging, PC Diagnostic Radiology CurrentSince Oct 1, 2003 Accepting new patients
Middle Tennessee Imaging, LLC CurrentSince Jan 1, 2019 Accepting new patients
Medical X-Ray Consultants, LTD Diagnostic Radiology CurrentSince Feb 1, 2021 Accepting new patients
Middle Tennessee Imaging, LLC CurrentSince Jan 1, 2019 Accepting new patients
Middle Tennessee Imaging LLC CurrentSince Jan 1, 2019 Accepting new patients
National Imaging Specialists PLLC Diagnostic Radiology Past Accepting new patients
Aj Medical Services, Inc Diagnostic Radiology Past Accepting new patients
K. Brian Walton, MD, PLC Past Accepting new patients
Sacred Heart Rehabilitation Institute, Inc. PastSince Jun 21, 2022 Accepting new patients

Locations

75 Remittance Dr
Dept 6244
Chicago, IL 60675

3024 Business Park Cir
Goodlettsvlle, TN 37072
Phone (615) 239-2018

1210 Briarville Rd
Bldg F602
Madison, TN 37115
Phone (615) 773-7237

28 White Bridge Pike
Ste 111
Nashville, TN 37205
Phone (615) 986-6153

3443 Dickerson Pike
Ste 400
Nashville, TN 37207
Phone (615) 612-2146

28 White Bridge Pike
Ste 104
Nashville, TN 37205

28 White Bridge Pike
Ste 314
Nashville, TN 37205
Phone (615) 986-6040

N112W15415 Mequon Rd
Germantown, WI 53022
Phone (262) 250-7800

6900 N Port Washington Rd
Glendale, WI 53217
Phone (414) 270-8100

2323 N Lake Dr
Milwaukee, WI 53211
Phone (414) 291-1000

1703 N Taylor Dr
Sheboygan, WI 53081
Phone (920) 457-4438

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322611200000",
    "number": "1710932017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3024 BUSINESS PARK CIR",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370723132",
            "telephone_number": "615-851-6033",
            "fax_number": "615-851-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3024 BUSINESS PARK CIR",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370723132",
            "telephone_number": "615-851-6033",
            "fax_number": "615-851-2018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIMMELFARB",
        "first_name": "ELLIOT",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2011-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "MD8191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID - MTI",
            "identifier": "1509269",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4068857",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TN",
            "identifier": "4200724",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY MEDICAID",
            "identifier": "64071590",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1509269",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4068499",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "PENDING",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - MTI",
            "identifier": "4291392",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3161070",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodlettsville, TN

Sources for this page

Verify at the official NPI Registry.