NPIMap

Individual provider Active NPI

Iwao K. Tanaka, M.D.

  • Diagnostic Radiology Physician
  • Williamsport, PA
National Provider Identifier
1730491192
Registry record updated Nov 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD444860 Issued in PA
Practice address
700 High St
Williamsport, PA 17701-3100
Phone
(570) 322-1161
Fax
(570) 322-2030
NPI assigned
Jul 13, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 245925 NY
Diagnostic Radiology Physician 2085R0202X MD444860 PA Primary

Addresses

Primary practice location

700 High St
Williamsport, PA 17701-3100

Mailing address

700 High St
Williamsport, PA 17701-3100
Phone (570) 322-1161

Other identifiers 1

IdentifierTypeStateIssuer
1027220260001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110616000204 NY Practitioner - Diagnostic Radiology 2264619444 Reassigns benefits to 1 organization
I20120629000338 PA Practitioner - Diagnostic Radiology 2264619444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Rutgers New Jersey Medical School, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Susquehanna Imaging Associates, Inc.Group PAC ID 3870482409, 8 clinicians

Practice addresses (Care Compare)

1100 Grampian Blvd
Williamsport, PA 17701-1907
Phone (570) 326-8171

1112 Grampian Blvd
Williamsport, PA 17701-1909
Phone (570) 326-8355

1205 River Ave
Williamsport, PA 17701-3724
Phone (570) 320-7407

140 W 22ND St
New York, NY 10011-2420
Phone (570) 322-1161

900 Plaza Dr
Montoursville, PA 17754-2448
Phone (570) 601-8550

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.99 of 100Reported as group
Quality
85.98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
245925NYMDLicensed Practical Nurse
MD444860PAMDDiagnostic Radiology Physician

Organizations & group practices 1

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.

Hospital & facility affiliations 40

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1278979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351728000000",
    "number": "1730491192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 HIGH ST",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177013100",
            "telephone_number": "570-322-1161",
            "fax_number": "570-322-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 HIGH ST",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177013100",
            "telephone_number": "570-322-1161",
            "fax_number": "570-322-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANAKA",
        "first_name": "IWAO",
        "middle_name": "K.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-13",
        "last_updated": "2012-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "245925",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD444860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027220260001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsport, PA

Sources for this page

Verify at the official NPI Registry.