Active NPI
Modesto Advanced Diagnostic Imaging Medical Center
Doing business as Modesto Advanced Diag Imaging Medical Center
- Diagnostic Radiology Physician
- Modesto, CA
National Provider Identifier
1730133893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- Legal business name
- MODESTO ADVANCED DIAGNOSTIC IMAGING MEDICAL CENTER
- Doing business as
- Modesto Advanced Diag Imaging Medical Center
- Practice address
- 157 E Coolidge Ave
Modesto, CA 95350-4504 - Phone
- (209) 524-6800
- Fax
- (209) 524-1286
- NPI assigned
- May 20, 2006
- Last updated
- Dec 29, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Howard G Berger, MD
- Title
- President
- Phone
- (310) 445-2800
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | Primary |
Addresses
Primary practice location
157 E Coolidge Ave
Modesto, CA 95350-4504
Mailing address
1516 Cotner Ave
Los Angeles, CA 90025-3303
Phone (310) 445-2951
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ01347Z | Other | CA | BLUE SHIELD |
| GR0047560 | Medicaid | CA |
Other names 1
- MODESTO ADVANCED DIAG IMAGING MEDICAL CENTER
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, RI, TX, OH, OR, AZ, ID, FL, TN, VA, CT, DC, IL, NY, NJ, NV, IA, MI, WI, NE
Enrollment records 20
National Provider Directory
National Provider DirectoryMember of 2
Organizations this organization is a member of, according to the National Provider Directory.
-
- Diagnostic Radiology Physician
- Los Angeles, CA
- NPI 1528099488
Member Of
Locations
1239 McHenry Ave
Ste A
Modesto, CA 95350
Phone (209) 491-5200
79 Scripps Dr
Ste 100
Sacramento, CA 95825
Phone (916) 921-1200
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Practitioners & affiliated clinicians
Practitioners 266
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.
-
- Vascular & Interventional Radiology Physician
- Sacramento, CA
- NPI 1184702847
-
- Diagnostic Radiology Physician
- Sacramento, CA
- NPI 1780691287
-
- Diagnostic Radiology Physician
- Modesto, CA
- NPI 1154345239
-
- Diagnostic Radiology Physician
- Glendale, CA
- NPI 1649222480
-
- Radiation Oncology Physician
- Oakland, CA
- NPI 1013900331
-
- Diagnostic Neuroimaging (Radiology) Physician
- Santa Monica, CA
- NPI 1700834496
Diagnostic Radiology
-
- Diagnostic Radiology Physician
- Thousand Oaks, CA
- NPI 1760431902
-
- Nuclear Radiology Physician
- Fresno, CA
- NPI 1750523031
-
- Diagnostic Radiology Physician
- Beverly Hills, CA
- NPI 1538514831
-
- Nuclear Imaging & Therapy Physician
- Stockton, CA
- NPI 1548328933
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148083200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1482969600000",
"number": "1730133893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1516 COTNER AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900253303",
"telephone_number": "310-445-2951",
"fax_number": "310-479-1459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "157 E COOLIDGE AVE",
"city": "MODESTO",
"state": "CA",
"postal_code": "953504504",
"telephone_number": "209-524-6800",
"fax_number": "209-524-1286"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MODESTO ADVANCED DIAGNOSTIC IMAGING MEDICAL CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-20",
"last_updated": "2016-12-29",
"status": "A",
"authorized_official_last_name": "BERGER",
"authorized_official_first_name": "HOWARD",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "310-445-2800",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "ZZZ01347Z",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0047560",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "MODESTO ADVANCED DIAG IMAGING MEDICAL CENTER",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Modesto, CA
- ML Wellness & Family Counseling, Inc
- Mobility Plus of California
- Navim Mobin, MD
- Modesto Acupuncture
- Modesto Adult Day Program Partners (Modesto Adult Day Program)
- Modesto Anesthesia Medical Group
- Modesto Arts Medical Group, Inc.
- Modesto Chiropractic Center, a Rosen Family Corp. (Modesto Chiropractic Center)
- Modesto City Schools
- Modesto Dermatology and Skin Cancer PC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2016; 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.