NPIMap

Organization Active NPI

Stand-Up MRI & Diagnostic Center Inc

  • Diagnostic Radiology Physician
  • Ormond Beach, FL
National Provider Identifier
1720053515
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
06-18617 Issued in FL
Legal business name
STAND-UP MRI & DIAGNOSTIC CENTER INC
Practice address
555 W Granada Blvd
Ormond Beach, FL 32174-9485
Phone
(386) 677-7730
Fax
(386) 677-7731
NPI assigned
Feb 23, 2006
Last updated
Mar 25, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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

Authorized official

Name
Timothy Damadian
Title
Owner
Phone
(631) 694-2929

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X 06-18617 FL Primary

Addresses

Primary practice location

555 W Granada Blvd
Ormond Beach, FL 32174-9485

Mailing address

555 W Granada Blvd
Ormond Beach, FL 32174-9485
Phone (386) 677-7730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031219000619 FL Part B Supplier - Clinic/Group Practice 0244138907 Receives reassigned benefits from 12 practitioners
Practice locations: Ormond Beach, FL
O20260423002285 NY Part B Supplier - Clinic/Group Practice 0244138907 Receives reassigned benefits from 1 practitioner
Practice locations: Melville, NY

National Provider Directory

National Provider Directory

Locations

1462 W International Speedway Blvd
Daytona Beach, FL 32114
Phone (386) 257-7713

555 W Granada Blvd
Ormond Beach, FL 32174
Phone (386) 254-8788

555 W Granada Blvd
Ste H1
Ormond Beach, FL 32174
Phone (386) 257-7713

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774396800000",
    "number": "1720053515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W GRANADA BLVD",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321749485",
            "telephone_number": "386-677-7730",
            "fax_number": "386-677-7731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W GRANADA BLVD",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321749485",
            "telephone_number": "386-677-7730",
            "fax_number": "386-677-7731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAND-UP MRI & DIAGNOSTIC CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-23",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A",
        "authorized_official_last_name": "DAMADIAN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-694-2929"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "06-18617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2026; 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.