Organization Active NPI

Icare360 Imaging LLC

  • Diagnostic Radiology Physician
  • Hudson, FL
National Provider Identifier
1720891005
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
ICARE360 IMAGING LLC
Practice address
7615 Jacque Rd
Hudson, FL 34667-7132
Phone
(813) 692-7947
Fax
(813) 692-7937
NPI assigned
Jan 30, 2025
Last updated
Jan 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Authorized official

Name
Dr. Vinod K Raxwal, MDNPI 1659386449
Title
Owner
Phone
(813) 692-7947

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

7615 Jacque Rd
Hudson, FL 34667-7132

Mailing address

7615 Jacque Rd
Hudson, FL 34667-7132
Phone (813) 692-7947

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250516001614 FL Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 8022540848 Practice locations: Hudson, FL

National Provider Directory

National Provider Directory
Tax ID family
Icare360 Imaging LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1738195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738195200000",
    "number": "1720891005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7615 JACQUE RD",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346677132",
            "telephone_number": "813-692-7947",
            "fax_number": "813-692-7937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7615 JACQUE RD",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346677132",
            "telephone_number": "813-692-7947",
            "fax_number": "813-692-7937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICARE360 IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-30",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A",
        "authorized_official_last_name": "RAXWAL",
        "authorized_official_first_name": "VINOD",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-692-7947",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; 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.