NPIMap

Organization Active NPI

Delta Radiology, Inc.

  • Specialist
  • Lodi, CA
National Provider Identifier
1740305846
Registry record updated Sep 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
DELTA RADIOLOGY, INC.
Practice address
1031 S Fairmont Ave
Lodi, CA 95240-5112
Phone
(209) 334-7810
NPI assigned
Mar 20, 2007
Last updated
Sep 12, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2018

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

Authorized official

Name
Daniel Wolcott
Title
President
Phone
(209) 339-7560

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1031 S Fairmont Ave
Lodi, CA 95240-5112

Mailing address

PO Box 15498
Sacramento, CA 95851-0498
Phone (559) 455-4000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041013000834 CA Part B Supplier - Clinic/Group Practice 5294795308 Receives reassigned benefits from 34 practitioners
8 other NPIs on this enrollment
Practice locations: Danville, CA; Stockton, CA; San Luis Obispo, CA; San Jose, CA; San Diego, CA; Sacramento, CA; Roseville, CA; Pleasanton, CA…

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Delta Radiology Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 35

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 35

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536710400000",
    "number": "1740305846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15498",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958510498",
            "telephone_number": "559-455-4000",
            "fax_number": "559-455-4007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 S FAIRMONT AVE",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952405112",
            "telephone_number": "209-334-7810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA RADIOLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2018-09-12",
        "status": "A",
        "authorized_official_last_name": "WOLCOTT",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-339-7560"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lodi, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2018; 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.