Excel Imaging LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

EXCEL IMAGING LLC

Doing business as

South Center Imaging

Practice address

415 Baker Blvd
Suite 100
Tukwila, WA 98188

Phone

(206) 439-8828

Fax

(206) 439-8878

NPI assigned

Nov 2, 2006

Organization subpart

No

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

Authorized official

Name

Beth Lupo

Title

Provider Relations Supervisor

Phone

(586) 412-4423

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• South Center Imaging Doing business as

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720166895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 BAKER BLVD",
            "address_2": "SUITE 110",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "98188",
            "telephone_number": "206-439-8828",
            "fax_number": "206-439-8878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 BAKER BLVD",
            "address_2": "SUITE 100",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "98188",
            "telephone_number": "206-439-8828",
            "fax_number": "206-439-8878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEL IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LUPO",
        "authorized_official_first_name": "BETH",
        "authorized_official_title_or_position": "PROVIDER RELATIONS SUPERVISOR",
        "authorized_official_telephone_number": "586-412-4423"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7119183",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Center Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Diagnostic Radiology Physician in Tukwila, WA
• Providers in Tukwila, WA by specialty
• Diagnostic Radiology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.